Molecular characteristics of resistance genes in rifampicin and isoniazid resistant Mycobacterium tuberculosis in Jiangxi Province
Objective To analyze the resistance rate and molecular characteristics of rifampicin/isoniazid-resistant Mycobacterium tuberculosis isolated in Jiangxi Province and to provide reference for the selection of drugs for composition of treatment regimen.Methods Whole genome sequencing was performed on 139 Mycobacterium tuberculosis strains that were resistant to rifampicin and/or isoniazid by phenotypic drug susceptibility test.The molecular characteristics and resistance to other anti-tuberculosis drugs were analyzed.Results Among 131 genotypic rifampicin-resistant strains,124(94.66％,124/131)occurred isoniazid resistance related genes.For group A drugs,70/131(53.44％)showed molecular changes associated with fluoroquinolone resistance,and 1/131(0.76％)was found mutation in linezolid resistance related gene.Two strains(1.53％,2/131)showed mutations in the cycloserine(group B drug)resistance gene.For group C drugs,the highest resistance rate was observed for ethambutol(59.54％,78/131).The main types of mutations in the resistance genes of rifampicin,isoniazid,fluoroquinolones,ethambutol,streptomycin,amikacin,and ethionimide were rpoB_p.Ser450Leu,katG_p.Ser315Thr,gyrA_p.Ala90Val,embB_p.Met306Val,rpsL_p.Lys43Arg,rrs_r.1401 a＞g,fabG1_c.-15C＞T,respectively.One linazolamide resistant mutation occurred in rplC_p.Cys154Arg.The pyrazinamide resistant mutations was scattered through the gene.Conclusion The resistance rate of fluoroquinolones among rifampicin-resistant strains is high in Jiangxi Province.Susceptibility testing should be conducted before initial of treatment.Population-based resistance surveillance should be carried out for drugs that cannot be routinely tested.
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