Cureus · 2026
Distribution of gyrA, rrs, and eis Gene Mutations Associated With Second-Line Drug Resistance Among Multidrug-Resistant Mycobacterium tuberculosis Isolates.
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Yadav Rinku, Bala Rosy, Parmar Aparna, Kaur Narinder, Singh Parminder
Аннотация
BACKGROUND: Drug-resistant tuberculosis (DR-TB) remains a major public health challenge, particularly with the increasing prevalence of resistance to second-line anti-tubercular drugs. Rapid detection of mutations associated with fluoroquinolone (FQ) and second-line injectable drug (SLID) resistance is essential for appropriate treatment selection and prevention of further drug resistance.
OBJECTIVES: To determine the genotypic patterns of second-line drug resistance among drug-resistant Mycobacterium tuberculosis isolates using GenoType MTBDRsl Version 2.0 (Hain Lifescience GmbH (a Bruker company), Nehren, Germany) and to characterize mutations associated with resistance to FQs and SLIDs.
METHODS: A cross-sectional study was conducted on 85 drug-resistant Mycobacterium tuberculosis isolates. GenoType MTBDRsl Version 2.0 assay was performed to detect mutations in the gyrA, gyrB, rrs, and eis genes associated with resistance to FQs and SLIDs. Isolates were categorized according to World Health Organization (WHO) resistance definitions.
RESULTS: A total of 85 drug-resistant Mycobacterium tuberculosis isolates were analyzed, including 42 (49.4%) isoniazid-resistant TB (Hr-TB), 14 (16.5%) rifampicin-resistant TB (RR-TB), and 29 (34.1%) multidrug-resistant TB (MDR-TB) isolates. FQ resistance was detected in 30 (35.3%) isolates, while seven (8.2%) were resistant to SLIDs. Based on final classification, 33 (38.8%) isolates were Hr-TB, nine (10.6%) Hr-TB with FQ resistance, nine (10.6%) RR-TB, five (5.9%) RR-TB with FQ resistance, 13 (15.3%) MDR-TB, and 16 (18.8%) pre-extensively drug-resistant (pre-XDR) TB. Among FQ-resistant isolates, the most common mutation was gyrA D94G (53.3%), followed by A90V (20.0%) and D94N/Y (16.7%). Among SLID-resistant isolates, rrs mutations predominated, with A1401G detected in 28.6% and G1484T in 14.3% of isolates. No isolated eis promoter mutations were observed.
OBJECTIVES: To determine the genotypic patterns of second-line drug resistance among drug-resistant Mycobacterium tuberculosis isolates using GenoType MTBDRsl Version 2.0 (Hain Lifescience GmbH (a Bruker company), Nehren, Germany) and to characterize mutations associated with resistance to FQs and SLIDs.
METHODS: A cross-sectional study was conducted on 85 drug-resistant Mycobacterium tuberculosis isolates. GenoType MTBDRsl Version 2.0 assay was performed to detect mutations in the gyrA, gyrB, rrs, and eis genes associated with resistance to FQs and SLIDs. Isolates were categorized according to World Health Organization (WHO) resistance definitions.
RESULTS: A total of 85 drug-resistant Mycobacterium tuberculosis isolates were analyzed, including 42 (49.4%) isoniazid-resistant TB (Hr-TB), 14 (16.5%) rifampicin-resistant TB (RR-TB), and 29 (34.1%) multidrug-resistant TB (MDR-TB) isolates. FQ resistance was detected in 30 (35.3%) isolates, while seven (8.2%) were resistant to SLIDs. Based on final classification, 33 (38.8%) isolates were Hr-TB, nine (10.6%) Hr-TB with FQ resistance, nine (10.6%) RR-TB, five (5.9%) RR-TB with FQ resistance, 13 (15.3%) MDR-TB, and 16 (18.8%) pre-extensively drug-resistant (pre-XDR) TB. Among FQ-resistant isolates, the most common mutation was gyrA D94G (53.3%), followed by A90V (20.0%) and D94N/Y (16.7%). Among SLID-resistant isolates, rrs mutations predominated, with A1401G detected in 28.6% and G1484T in 14.3% of isolates. No isolated eis promoter mutations were observed.