AUTHOR=Thomsen Jens , Abdulrazzaq Najiba M. , Nyasulu Peter S. , Al Hosani Farida , Habous Maya , Weber Stefan , Jabeen Fouzia , The UAE AMR Surveillance Consortium , Menezes Godfred Antony , Moubareck Carole Ayoub , Senok Abiola , Everett Dean B. , Senok Abiola , Alatoom Adnan , Sonnevend-Pal Agnes , Hammadi Ahmed Abdulkareem Al , Ahmed Ahmed Elhag , Yousef Ahmed F. , Enshasy Alaa MM , Madhi Amal Mubarak , AlBlooshi Amna , Podbielski Andreas , Nabi Anju , Poddar Anup Shashikant , Jha Arun Kumar , Marzooqi Ayesha Abdulla Al , Aden Bashir , Moubareck Carole Ayoub , Everett Dean , Jafri Deeba , Hong Duckjin , Nsutebu Emmanuel Fru , Al-Marzooq Farah Ibrahim , Dhaheri Fatima Al , Jabeen Fouzia , Selvaraj Francis Amirtharaj , Wahab Ghada Abdel , Khoder Ghalia Abdul Khader , Patil Gitanjali Avishkar , Menezes Godfred A. , Hadayatullah Muhammad Ghulam , Ahmad Hafiz , Ismail Hala Ahmed Fouad , Khalifa Hazim , Alzabi Husein , Alhashami Ibrahim Alsayed Mustafa , Lazreg Imene , Akthar Irfaan , Thomsen Jens , Stelling John , Kayaf Kaltham Ali , Diddi Kavita , Ramabhadran Krishnaprasad , Dabal Laila Al , Thomsen Laura , Leili Chamani-Tabriz , Senghore Madikay , Ahmed Manal Abdel Fattah , Habous Maya , Zain Moeena , Mohamud M. Sheek-Hussein , Maheshwari Monika , Maheshwari Monika , Alfaresi Mubarak Saif , Khan Mushtaq , Abdulrazzaq Najiba , Shirawi Nehad Nabeel Al , Helmy Nesrin , Murad Pamela Fares , Frey Pascal , Nyasulu Peter , Nasa Prashant , Rajeshwari T. A. Patil , Lababidi Rania El , Kurahatti Ratna A. , Husain Riyaz Amirali , Swaka Robert Lodu Serafino Wani , Hussein Saeed , Soliman Sameh , Mudalagiriyappa Savitha , Oommen Seema , Alkaabi Shaikha Ghannam , Jog Simantini , Jog Simantini , O‘Sullivan, Siobhan , Basu Somansu , Weber Stefan , Majeed Sura Khamees , Rizvi Syed Irfan Hussein , Pal Tibor , Collyns Timothy Anthony , Ali Yassir Mohammed Eltahir , Naqvi Yousuf Mustafa , Babiker Zahir Osman , Zulfa Omar Al Deesi TITLE=Epidemiology and antimicrobial resistance of Mycobacterium spp. in the United Arab Emirates: a retrospective analysis of 12 years of national antimicrobial resistance surveillance data JOURNAL=Frontiers in Public Health VOLUME=12 YEAR=2024 URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1244353 DOI=10.3389/fpubh.2024.1244353 ISSN=2296-2565 ABSTRACT=Introduction

The Eastern Mediterranean Regional Office (EMRO) region accounts for almost 8% of all global Mycobacterium tuberculosis (TB) cases, with TB incidence rates ranging from 1 per 100,000 per year in the United Arab Emirates (UAE) to 204 per 100,000 in Djibouti. The national surveillance data from the Middle East and North Africa (MENA) region on the epidemiology and antimicrobial resistance trends of TB, including MDR-TB remains scarce.

Methods

A retrospective 12-year analysis of N = 8,086 non-duplicate diagnostic Mycobacterium tuberculosis complex (MTB complex) isolates from the UAE was conducted. Data were generated through routine patient care during the 2010–2021 years, collected by trained personnel and reported by participating surveillance sites to the UAE National Antimicrobial Resistance (AMR) Surveillance program. Data analysis was conducted with WHONET, a windows-based microbiology laboratory database management software developed by the World Health Organization Collaborating Center for Surveillance of Antimicrobial Resistance, Boston, United States (https://whonet.org/).

Results

A total of 8,086 MTB-complex isolates were analyzed. MTB-complex was primarily isolated from respiratory samples (sputum 80.1%, broncho-alveolar lavage 4.6%, pleural fluid 4.1%). Inpatients accounted for 63.2%, including 1.3% from ICU. Nationality was known for 84.3% of patients, including 3.8% Emiratis. Of UAE non-nationals, 80.5% were from 110 countries, most of which were Asian countries. India accounted for 20.8%, Pakistan 13.6%, Philippines 12.7%, and Bangladesh 7.8%. Rifampicin-resistant MTB-complex isolates (RR-TB) were found in 2.8% of the isolates, resistance to isoniazid, streptomycin, pyrazinamide, and ethambutol, was 8.9, 6.9, 3.4 and 0.4%, respectively. A slightly increasing trend of resistance among MTB-complex was observed for rifampicin from 2.5% (2010) to 2.8% (2021).

Conclusion

Infections due to MTB-complex are relatively uncommon in the United Arab Emirates compared to other countries in the MENA region. Most TB patients in the UAE are of Asian origin, mainly from countries with a high prevalence of TB. Resistance to first line anti-tuberculous drugs is generally low, however increasing trends for MDR-TB mainly rifampicin linked resistance is a major concern. MDR-TB was not associated with a higher mortality, admission to ICU, or increased length of hospitalization as compared to non-MDR-TB.