Molecular mechanisms of drug-resistance in MDRstrains of M. tuberculosis; Research Article

31-Dec-2020 12:00 AM 4662

Aim: The Present study was conducted to detect pattern and mechanisms of drug resistance in isolates of Mycobacterium tuberculosis in a tertiary care hospital in Western Maharashtra. Material and Methods: Total 1186 sputum samples from clinically suspected Tuberculosis patients were screened for the presence of M. tuberculosis, acid-fast bacilli (AFB) by Ziehl-Neelsen staining technique. Out of that, 130 were smear positive showing presence of AFB. Out of these, 123 were successfully cultivated on Lowenstein-Jensen’s media showing typical colonies of M.tuberculosis, which were confirmed by standard biochemical tests. The drug susceptibility testing (DST) of all these isolates for first line anti-tubercular drugs was performed by phenotypic –gold standard “proportion method” and only 10 isolates were resistant to rifampicin and isoniazid i.e. multi-drug resistant (MDR) strains. The molecular mechanisms of resistance to these drugs was identified by detecting the mutations in the rpoB gene (for Rifampicin resistance) and inhA gene (high level INH resistance) and katG gene (low level INH resistance) by using MTBDRplus assay. Results: Out of the 10 phenotypically identified MDR-TB strains, in 8 strains, Rifampicin (RMP) resistance was associated with the missing of rpoB WT8 gene while missing of rpoB WT7, 8 and rpoB WT4, 5 was observed in two different strains. High level Isoniazid (INH) resistance was observed in 5 strains showing presence of katG MUT1 band while low level Isoniazid (INH) resistance was observed in 5 strains; showing presence of inhA MUT3A band in 2 strains and inhA MUT 3B band in 3 strains. In the present study MDR-TB, rate was 8.13%. Conclusion: Identification of mutations in the genes of M. tuberculosis by MTBDRplus is a rapid method to detect the MDR-TB strains of M. tuberculosis.

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