Correlation between GenoType MTBDR plus Assay and Phenotypic Susceptibility Test for Prothionamide in Patients with Genotypic Isoniazid Resistance

Tuberculosis and Respiratory Diseases

article

Joo Hee Lee¹  Kyung-Wook Jo¹  Tae Sun Shim¹ 

[1] Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine

关键词: katG Protein;    InhA Protein;    Isoniazid;    Prothionamide;    Genotype;    Biological Assay;    Disease Susceptibility;    Research Design;    Mycobacterium tuberculosis;    Mycobacterium;   

DOI  :  10.4046/trd.2018.0027

学科分类：医学（综合）

来源: The Korean Academy of Tuberculosis and Respiratory Diseases

【 摘 要 】

Background The purpose of this study was to analyze the relationship between the gene mutation patterns by the GenoType MTBDR plus (MTBDR plus ) assay and the phenotypic drug susceptibility test (pDST) results of isoniazid (INH) and prothionamide (Pto). Methods A total of 206 patients whose MTBDR plus assay results revealed katG or inhA mutations were enrolled in the study. The pDST results were compared to mutation patterns on the MTBDR plus assay. Results The katG and inhA mutations were identified in 68.0% and 35.0% of patients, respectively. Among the 134 isolated katG mutations, three (2.2%), 127 (94.8%) and 11 (8.2%) were phenotypically resistant to low-level INH, high-level INH, and Pto, respectively. Among the 66 isolated inhA mutations, 34 (51.5%), 18 (27.3%) and 21 (31.8%) were phenotypically resistant to low-level INH, high-level INH, and Pto, respectively. Of the 34 phenotypic Pto resistant isolates, 21 (61.8%), 11 (32.4%), and two (5.9%) had inhA , katG , and both gene mutations. Conclusion It is noted that Pto may still be selected as one of the appropriate multidrug-resistant tuberculosis regimen, although inhA mutation is detected by the MTBDR plus assay until pDST confirms a Pto resistance. The reporting of detailed mutation patterns of the MTBDR plus assay may be important for clinical practice, rather than simply presenting resistance or susceptibility test results.

【 授权许可】

CC BY-NC