The molecular patterns of resistance to anti-tuberculosis drugs: an analysis from Istanbul, Turkey

Abstract

Resistances to anti-tuberculosis (TB) drugs are related to the mutations in the genome of the Mycobacterium tuberculosis complex (MTBC). To expose the genomic mutations that cause anti-TB drug resistance. The GenoType MTBDRplus and MTBDRsl assays were used to detect genetic mutations. In this study of 1329 MTBC isolates, the sensitivities and specificities of genotypic methods for the detection of isoniazid (INH), rifampicin (RIF), ethambutol (EMB), and multi-drug resistance were 0.77, 0.84, 0.65, 0.89 and 0.99, 0.98, 0.67, 0.94, respectively. MUT3 mutations (S531L) of the rpoB gene for RIF resistance and MUT1 mutations (S315T1 and C15T) of the katG and inhA genes for INH resistance were dominant. The most frequently observed mutations that created resistance to fluoroquinolones (FLQ) were MUT3C (D94G) of the gyrA gene. The predominant mutations of EMB resistance were MUT1B (M306V) of the embB gene. Aminoglycosides/cyclic peptides (AG/CP) resistance was rare. The molecular mechanisms of anti-TB drugs resistance in MTBC strains found in Istanbul are similar to those in the literature.

Keywords:

• Genotype MTBDRplus
• Genotype MTBDRsl
• Mycobacterium tuberculosis
• drug resistance
• MDR-TB
• XDR-TB

Acknowledgment

We would like to thank V. Yazisiz for contributing of statistical analysis and drafting the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Author contributions

Yazisiz H contributed to design of the study, analysis, reviewed the literatüre, interpretation of data and drafting the manuscript; Cenger DH collected data, analysis and reviewed the literature; Uçarman N contributed to analysis of molecular testes and interpretation of data; Altın S was responsible for the revision of the manuscript for important intellectual content; All authors issued approval for the final version to be submitted.

Notes on contributors

Hatice Yazisiz, Microbiology specialist, is a assistant professor at the Department of Microbiology, University of Akdeniz, Antalya, Turkey. Previoulsy, she worked at Tuberculosis laboratory in Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul.

Derya Hircin Cenger is Clinic of Infectious Diseases and Clinical Microbiology specialist at the Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul.

Nilay Uçarman, Microbiology specialist, is working at the Public Health Agency of Turkey, National Tuberculosis Reference Laboratory, Ankara.

Sedat Altin, Chest disease and tuberculosis spesialist, is a professor at the Clinic of Chest Diseases in Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul.

Additional information

Funding

This research was not funded by grants or another funding agency