Comparison Of drrA And drrB Efflux Pump Genes Expression In Drug-Susceptible And -Resistant Mycobacterium tuberculosis Strains Isolated From Tuberculosis Patients In Iran

Figures & data

Table 1 The Sequence Of Primers Of The Genes Used In This Study

No.	Gene		Primer Sequence (5′→3′)	Amplicon Size (bp)
1	drrA	Forward	TAGACATCGCGTGCGGATTGGT	147
		Reverse	GCGTGGTCAACAACGTGGCAAT
2	drrB	Forward	TCGCCAGCAACTTAGGGCAATACA	233
		Reverse	TCCGATGACGTAGCCGCAAACTAG
3	polA	Forward	TCCGATGACGTAGCCGCAAACTAG	181
		Reverse	GTCGTGGTTGGACCTTGGAGGG

Table 2 The Results From Phenotypic Drug Susceptibility Testing And Relevant drrA And drrB Gene Expression Fold Changes For MTB Isolates

Patients No.	Resistance Pattern	drrA Fold Changes	drrB Fold Changes	Patient No.	Resistance Pattern	drrA Fold Changes	drrB Fold Changes
1	RIF	6.7	4.8	20	S	1.3	2.3
2	MDR	23.62	10.7	21	RIF	0.2	2.9
3	MDR	18.53	4.07	22	S	1.6	0.6
4	MDR	23.51	4.1	23	S	0.4	1.2
5	MDR	27.93	5.23	24	S	0.3	1.4
6	MDR	19.8	3.08	25	S	0.3	1.9
7	RIF	23.19	4.15	26	S	0.2	1.02
8	RIF	0.98	3.34	27	RIF	0.5	3.05
9	RIF	4.8	4.24	28	RIF	0.3	15.46
10	RIF	3.06	1.9	29	S	0.4	2.3
11	RIF	12.7	3.6	30	INH	4.7	2.3
12	RIF	17.86	3.5	31	INH	6.9	7.1
13	RIF	27.17	2.9	32	S	0.4	0.38
14	RIF	13.38	2.1	33	INH	6.01	5.4
15	RIF	5.6	0.1	34	S	0.1	0.2
16	S	1.1	2.1	35	S	0.2	0.3
17	RIF	0.4	5.07	36	S	0.2	0.3
18	RIF	0.7	2.5	37	S	0.1	0.01
19	RIF	0.3	4.01

Abbreviations: RIF, rifampin; INH, isoniazid; MDR, multidrug resistant; S, susceptible.

Table 3 Correlation Of Genes Expression Fold Changes Of drrA And drrB In Mycobacterium Tuberculosis Isolates With Various Drug-Resistance Patterns

Resistance Phenotype	drrA Expression No.(%)	P value	drrB Expression No.(%)	P value
RIF monoresistant	9 (56.25)	0.025	14(87.5)	0.025
INH monoresistant	3 (100)	0.1	3 (100)	0.1
MDR	5 (100)	0.009	5 (100)	0.09

Figure 1 The drrA gene expression fold comparison of different groups of MTB isolates as per DST results.

Figure 2 The drrB gene expression fold comparison of different groups of MTB isolates as per DST results. Note that a rifampin-resistant isolate showed very high levels of drrB gene expression which is shown by a dot on the FIGURE as an outlier.

Figure 3 Comparative ROC curve for drrA and drrB genes. Statistical analysis showed that there is no meaningful difference between drrA and drrB genes considering diagnostic accuracy (P value= 0.4045).