Variations in the Occurrence of Specific RpoB Mutations in Rifampicin-resistant Mycobacterium Tuberculosis Isolates from Patients of Different Ethnic Groups in Kuwait

Overview

Journal Indian J Med Res

Specialty General Medicine

Date 2012 Jul 10

PMID 22771609

Citations 13

Authors

Suhail Ahmad

Noura M Al-Mutairi

Eiman Mokaddas

Affiliations

Soon will be listed here.

Abstract

Background & Objectives: Frequency of resistance-conferring mutations vary among isoniazid- and ethambutol-resistant Mycobacterium tuberculosis isolates obtained from patients of various ethnic groups. This study was aimed to determine the occurrence of specific rpoB mutations in rifampicin-resistant M. tuberculosis isolates from tuberculosis patients of various ethnic groups in Kuwait.

Methods: Rifampicin-resistant M. tuberculosis isolates (n=119) from South Asian (n=55), Southeast Asian (n=23), Middle Eastern (n=39) and other (n=2) patients and 107 rifampicin-susceptible isolates were tested. Mutations in rpoB were detected by DNA sequencing. Polymorphisms at katG463 and gyrA95 were detected by PCR-RFLP for genetic group assignment.

Results: None of rifampicin-susceptible but 116 of 119 rifampicin-resistant isolates showed rpoB mutation(s). Mutations among isolates from South Asian patients were distributed at rpoB516 (20%), rpoB526 (24%) and rpoB531 (27%) while 78 and 51 per cent of isolates from Southeast Asian and Middle Eastern patients, respectively, contained a mutated rpoB531. All isolates with rpoB N-terminal and cluster II mutations were obtained from Middle Eastern and South Asian patients. Most isolates from South Asian (84%) and Southeast Asian (70%) patients belonged to genetic group I while nearly all remaining isolates belonged to genetic group II. Isolates from Middle Eastern patients were distributed among genetic group I (46%), genetic group II (33%) and genetic group III (21%).

Interpretation & Conclusions: The occurrence of specific rpoB mutations varied considerably in rifampicin-resistant M. tuberculosis isolates obtained from patients of different ethnic groups within the same country. The present data have important implications for designing region-specific rapid methods for detecting majority of rifampicin-resistant strains.

Citing Articles

First insights into the phylogenetic diversity of Mycobacterium tuberculosis in Kuwait and evaluation of REBA MTB-MDR assay for rapid detection of MDR-TB.

Al-Mutairi N, Ahmad S, Mokaddas E, Al-Hajoj S PLoS One. 2022; 17(10):e0276487.

PMID: 36264939 PMC: 9584360. DOI: 10.1371/journal.pone.0276487.

Emerging Status of Multidrug-Resistant Bacteria and Fungi in the Arabian Peninsula.

Borgio J, Rasdan A, Sonbol B, Alhamid G, Almandil N, AbdulAzeez S Biology (Basel). 2021; 10(11).

PMID: 34827138 PMC: 8614875. DOI: 10.3390/biology10111144.

The Spectrum of Spontaneous Rifampin Resistance Mutations in the Bacillus subtilis Gene Depends on the Growth Environment.

Leehan J, Nicholson W Appl Environ Microbiol. 2021; 87(22):e0123721.

PMID: 34495706 PMC: 8552901. DOI: 10.1128/AEM.01237-21.

Current Epidemiological Characteristics of Imported Malaria, Vector Control Status and Malaria Elimination Prospects in the Gulf Cooperation Council (GCC) Countries.

Iqbal J, Ahmad S, Sher A, Al-Awadhi M Microorganisms. 2021; 9(7).

PMID: 34361867 PMC: 8307262. DOI: 10.3390/microorganisms9071431.

Increasing prevalence of resistance to second-line drugs among multidrug-resistant Mycobacterium tuberculosis isolates in Kuwait.

Al-Mutairi N, Ahmad S, Mokaddas E Sci Rep. 2021; 11(1):7765.

PMID: 33833390 PMC: 8032671. DOI: 10.1038/s41598-021-87516-0.

References

Heep M, Brandstatter B, Rieger U, Lehn N, Richter E, Rusch-Gerdes S . Frequency of rpoB mutations inside and outside the cluster I region in rifampin-resistant clinical Mycobacterium tuberculosis isolates. J Clin Microbiol. 2001; 39(1):107-10. PMC: 87688. DOI: 10.1128/JCM.39.1.107-110.2001. View

Hwang H, Chang C, Chang L, Chang S, Chang Y, Chen Y . Characterization of rifampicin-resistant Mycobacterium tuberculosis in Taiwan. J Med Microbiol. 2003; 52(Pt 3):239-245. DOI: 10.1099/jmm.0.05045-0. View

Mokrousov I, Narvskaya O, Otten T, Limeschenko E, Steklova L, Vyshnevskiy B . High prevalence of KatG Ser315Thr substitution among isoniazid-resistant Mycobacterium tuberculosis clinical isolates from northwestern Russia, 1996 to 2001. Antimicrob Agents Chemother. 2002; 46(5):1417-24. PMC: 127151. DOI: 10.1128/AAC.46.5.1417-1424.2002. View

Ahmad S, Mokaddas E . The occurrence of rare rpoB mutations in rifampicin-resistant clinical Mycobacterium tuberculosis isolates from Kuwait. Int J Antimicrob Agents. 2005; 26(3):205-12. DOI: 10.1016/j.ijantimicag.2005.06.009. View

Sintchenko V, Chew W, Jelfs P, Gilbert G . Mutations in rpoB gene and rifabutin susceptibility of multidrug-resistant Mycobacterium tuberculosis strains isolated in Australia. Pathology. 1999; 31(3):257-60. DOI: 10.1080/003130299105089. View

Palomino J, Martin A, Groll A, Portaels F . Rapid culture-based methods for drug-resistance detection in Mycobacterium tuberculosis. J Microbiol Methods. 2008; 75(2):161-6. DOI: 10.1016/j.mimet.2008.06.015. View

Sreevatsan S, Pan X, Stockbauer K, Connell N, Kreiswirth B, Whittam T . Restricted structural gene polymorphism in the Mycobacterium tuberculosis complex indicates evolutionarily recent global dissemination. Proc Natl Acad Sci U S A. 1997; 94(18):9869-74. PMC: 23284. DOI: 10.1073/pnas.94.18.9869. View

Ahmad S, Mokaddas E, Jaber A . Rapid detection of ethambutol-resistant Mycobacterium tuberculosis strains by PCR-RFLP targeting embB codons 306 and 497 and iniA codon 501 mutations. Mol Cell Probes. 2004; 18(5):299-306. DOI: 10.1016/j.mcp.2004.04.001. View

Ahmad S . New approaches in the diagnosis and treatment of latent tuberculosis infection. Respir Res. 2010; 11:169. PMC: 3004849. DOI: 10.1186/1465-9921-11-169. View

10.

Ahmad S, Mokaddas E . Recent advances in the diagnosis and treatment of multidrug-resistant tuberculosis. Respir Med. 2009; 103(12):1777-90. DOI: 10.1016/j.rmed.2009.07.010. View

11.

Ahmad S, Mokaddas E . Contribution of AGC to ACC and other mutations at codon 315 of the katG gene in isoniazid-resistant Mycobacterium tuberculosis isolates from the Middle East. Int J Antimicrob Agents. 2004; 23(5):473-9. DOI: 10.1016/j.ijantimicag.2003.10.004. View

12.

Hirano K, Abe C, Takahashi M . Mutations in the rpoB gene of rifampin-resistant Mycobacterium tuberculosis strains isolated mostly in Asian countries and their rapid detection by line probe assay. J Clin Microbiol. 1999; 37(8):2663-6. PMC: 85308. DOI: 10.1128/JCM.37.8.2663-2666.1999. View

13.

Mokaddas E, Ahmad S, Abal A, Al-Shami A . Molecular fingerprinting reveals familial transmission of rifampin-resistant tuberculosis in Kuwait. Ann Saudi Med. 2005; 25(2):150-3. PMC: 6147960. DOI: 10.5144/0256-4947.2005.150. View

14.

Jou R, Chen H, Chiang C, Yu M, Su I . Genetic diversity of multidrug-resistant Mycobacterium tuberculosis isolates and identification of 11 novel rpoB alleles in Taiwan. J Clin Microbiol. 2005; 43(3):1390-4. PMC: 1081303. DOI: 10.1128/JCM.43.3.1390-1394.2005. View

15.

Ahmad S, Jaber A, Mokaddas E . Frequency of embB codon 306 mutations in ethambutol-susceptible and -resistant clinical Mycobacterium tuberculosis isolates in Kuwait. Tuberculosis (Edinb). 2007; 87(2):123-9. DOI: 10.1016/j.tube.2006.05.004. View

16.

Abal A, Ahmad S, Mokaddas E . Variations in the occurrence of the S315T mutation within the katG gene in isoniazid-resistant clinical Mycobacterium tuberculosis isolates from Kuwait. Microb Drug Resist. 2002; 8(2):99-105. DOI: 10.1089/107662902760190644. View

17.

Mokaddas E, Ahmad S . Development and evaluation of a multiplex PCR for rapid detection and differentiation of Mycobacterium tuberculosis complex members from non-tuberculous mycobacteria. Jpn J Infect Dis. 2007; 60(2-3):140-4. View

18.

Ahmad S, Mokaddas E, Fares E . Characterization of rpoB mutations in rifampin-resistant clinical Mycobacterium tuberculosis isolates from Kuwait and Dubai. Diagn Microbiol Infect Dis. 2002; 44(3):245-52. DOI: 10.1016/s0732-8893(02)00457-1. View

19.

Nikolayevsky V, Brown T, Balabanova Y, Ruddy M, Fedorin I, Drobniewski F . Detection of mutations associated with isoniazid and rifampin resistance in Mycobacterium tuberculosis isolates from Samara Region, Russian Federation. J Clin Microbiol. 2004; 42(10):4498-502. PMC: 522290. DOI: 10.1128/JCM.42.10.4498-4502.2004. View

20.

Ahmad S, Itani L, Fares E, Araj G . Varying prevalence of embB codon 306 mutations in ethambutol-resistant clinical Mycobacterium tuberculosis isolates from Beirut and Dubai. J Chemother. 2008; 20(2):285-7. DOI: 10.1179/joc.2008.20.2.285. View