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Volume 19, Number 10—October 2013

Dispatch

Primary Multidrug-Resistant Mycobacterium tuberculosis in 2 Regions, Eastern Siberia, Russian Federation

Svetlana Zhdanova1, Scott K. Heysell1Comments to Author , Oleg Ogarkov, Galina Boyarinova, Galina Alexeeva, Suporn Pholwat, Elena Zorkaltseva, Eric R. Houpt, and Eugeniy Savilov
Author affiliations: Russian Academy of Medical Sciences, Irkutsk, Russian Federation (S. Zhdanova, O. Ogarkov, E. Savilov); University of Virginia, Charlottesville, Virginia, USA (S.K. Heysell, G. Boyarinova, S. Pholwat, E.R. Houpt); Regional TB-Prevention Dispensary, Irkutsk (O. Ogarkov, E. Zorkaltseva); Research Practice Center for Phthisiatry, Yakutsk, Russian Federation (G. Alexeeva); State Medical Continuing Education Academy, Irkutsk (E. Zorkaltseva, E. Savilov)

Main Article

Table 2

Resistance mutations in Mycobacterium tuberculosis from 51 patients from Irkutsk and Yakutia, Russian Federation*

Drug, locus
Mutation, no. (% total) Drug resistance, no. (% with mutation)
Amino acid change
Nucleotide change
Isoniazid
katG Ser315Thr 28 (55) 25 (89)
Ser315Thr/Trp321Cys 4 (7) 4 (100)
Trp321Cys 1 (2) 1 (100)
Thr322Ala 1 (2) 0
No mutation 8 (16) 3 (38)
No amplification 9 (18) 8 (89)
inhA C(−15)T 3 (6) 3 (100)
T(−8)A 1 (2) 1 (100)
G (−13)T 1 (2) 1 (100)
No mutation 41 (80) 32 (78)
No amplification 4 (7) 4 (100)
Rifampin, rpoB Ser531Leu 19 (37) 15 (79)
Ser531Leu/Thr481Ala 1 (2) 0
Ser 531Leu/Thr480Ile 2 (4) 2 (100)
Ser531Tryp/Val456Gly 1 (2) 1 (100)
Gln513Lys 2 (4) 2 (100)
Leu533Pro 1 (2) 1 (100)
His516Tyr 1 (2) 1 (100)
Leu511Pro 1 (2) 0
No mutation 22 (43) 6 (27)
No amplification 1 (2) 0
Fluoroquinolones, gyrA Not performed
Ser95Thr 46 (90)†
Asp94Gly 1 (2)
Asp94Ala 1 (2)
Ala90Val 1 (2)
No amplification 2 (4)
Ethambutol, embB Asp354Ala 3 (6) 1 (33)
Asp354Ala/Gly406Asp 1 (2) 0
Met306Val 3 (6) 3 (100)
Met306Ile 3 (6) 3 (100)
Gly406Ser 3 (6) 2 (67)
Gly406Ala 2 (4) 0
Gly406Cyst 1 (2) 1 (100)
No mutation 25 (49) 9 (36)
No amplification 10 (20) 3 (30)
Not performed
Pyrazinamide, pncA Gly113Phe 3 (6)§ G338T and C96T
Leu19Arg 2 (4)§ T56G
Gly113Phe/Arg121 Leu 1 (2)§ G338T and C96T/ G362T
Arg121Leu 1(2)§ G362T
Gln10Pro 1 (2) A29C
Val7Gly 1 (2) T20G /G481C
Ala161Pro/ Val155Ala 1 (2)§ G203A
His137Asp/ Frameshift 1 (2)§ T464C/ insertion C480
Tryp68Stop 1 (2)§ C409G
Frameshift 1 (2)§ deletionG5
No mutation 8 (14)
No amplification 30 (59)
Kanamycin
rrs A1401G 4 (57) 3 (75)
C1443G 3 (43) 1 (33)
No mutation 35 12 (34)
No amplification 9 3 (33)
eis G(−10)A 4 (44) 2 (50)¶
C(−14)T 1 (11) 1 (100)¶
C(−15)G 2 (22) 0
C(−14)G 1 (11) 0
C(−12)T 1 (11) 0
No mutation 36 11
No amplification 6 3 (50)

*Blank cells indicate not applicable. All inhA mutations were associated with a Ser315Thr mutation in katG except for 1 isolate in which katG did not amplify.
†Previously demonstrated not to be associated with phenotypic resistance.
‡Excluding 25 silent pncA mutations (Ser32Ser most common, n = 14).
§Mutations in pncA not previously reported. Conventional susceptibility testing was unavailable for pyrazinamide and the fluoroquinolones.
¶For all 3 mutations of eis associated with kanamycin resistance, rrs was wild type.

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1These authors contributed equally to this article.

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