Beijing genotype of Mycobacterium tuberculosis is significantly associated with high-level fluoroquinolone resistance in Vietnam.
Consecutive fluoroquinolone (FQ)-resistant isolates (n = 109) identified at the Pham Ngoc Thach Hospital for Tuberculosis, Ho Chi Minh City, Vietnam, were sequenced in the quinolone resistance-determining regions of the gyrA and gyrB genes and typed by large sequence polymorphism typing and spoligot...
Main Authors: | , , , , , , , , , , |
---|---|
Format: | Journal article |
Language: | English |
Published: |
2009
|
_version_ | 1797053183221039104 |
---|---|
author | Duong, D Nguyen, T Nguyen, T Dai, V Dang, T Vo, S Do, D Nguyen, V Nguyen, H Dinh, N Farrar, J Caws, M |
author_facet | Duong, D Nguyen, T Nguyen, T Dai, V Dang, T Vo, S Do, D Nguyen, V Nguyen, H Dinh, N Farrar, J Caws, M |
author_sort | Duong, D |
collection | OXFORD |
description | Consecutive fluoroquinolone (FQ)-resistant isolates (n = 109) identified at the Pham Ngoc Thach Hospital for Tuberculosis, Ho Chi Minh City, Vietnam, were sequenced in the quinolone resistance-determining regions of the gyrA and gyrB genes and typed by large sequence polymorphism typing and spoligotyping to identify the Beijing genotype of Mycobacterium tuberculosis. Beijing genotype prevalence was compared with 109 consecutive isolates from newly presenting patients with pulmonary tuberculosis from the hospital outpatient department. Overall, 82.6% (n = 90/109) of isolates had mutations in gyrAB. Nine novel mutations were identified in gyrB (S486F, N538T, T539P, D500A, D500H, D500N, G509A, E540V, and E540D). The influence of these novel gyrB mutations on FQ resistance is not proven. The Beijing genotype was significantly associated with FQ resistance (odds ratio [OR], 2.39 [95% confidence interval {CI}, 1.34 to 4.25]; P = 0.003). Furthermore, Beijing genotype FQ-resistant isolates were significantly more likely than FQ-resistant isolates of other genotypes to have gyrA mutations (OR, 7.75 [95% CI, 2.84 to 21.15]; P = 0.0001) and high-level (>8 microg/ml) FQ resistance (OR, 11.0 [95% CI, 2.6 to 47.0]; P = 0.001). The underlying mechanism of the association of the Beijing genotype with high-level FQ resistance in this setting remains to be determined. The association of the Beijing genotype with relatively high-level FQ resistance conferred by specific gyrA mutations reported here is of grave concern given the epidemic spread of the Beijing genotype and the current hopes for shorter first-line treatment regimens based on FQs. |
first_indexed | 2024-03-06T18:40:26Z |
format | Journal article |
id | oxford-uuid:0caec06e-65ca-4326-ae44-4aa1bd47ad9a |
institution | University of Oxford |
language | English |
last_indexed | 2024-03-06T18:40:26Z |
publishDate | 2009 |
record_format | dspace |
spelling | oxford-uuid:0caec06e-65ca-4326-ae44-4aa1bd47ad9a2022-03-26T09:36:18ZBeijing genotype of Mycobacterium tuberculosis is significantly associated with high-level fluoroquinolone resistance in Vietnam.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:0caec06e-65ca-4326-ae44-4aa1bd47ad9aEnglishSymplectic Elements at Oxford2009Duong, DNguyen, TNguyen, TDai, VDang, TVo, SDo, DNguyen, VNguyen, HDinh, NFarrar, JCaws, MConsecutive fluoroquinolone (FQ)-resistant isolates (n = 109) identified at the Pham Ngoc Thach Hospital for Tuberculosis, Ho Chi Minh City, Vietnam, were sequenced in the quinolone resistance-determining regions of the gyrA and gyrB genes and typed by large sequence polymorphism typing and spoligotyping to identify the Beijing genotype of Mycobacterium tuberculosis. Beijing genotype prevalence was compared with 109 consecutive isolates from newly presenting patients with pulmonary tuberculosis from the hospital outpatient department. Overall, 82.6% (n = 90/109) of isolates had mutations in gyrAB. Nine novel mutations were identified in gyrB (S486F, N538T, T539P, D500A, D500H, D500N, G509A, E540V, and E540D). The influence of these novel gyrB mutations on FQ resistance is not proven. The Beijing genotype was significantly associated with FQ resistance (odds ratio [OR], 2.39 [95% confidence interval {CI}, 1.34 to 4.25]; P = 0.003). Furthermore, Beijing genotype FQ-resistant isolates were significantly more likely than FQ-resistant isolates of other genotypes to have gyrA mutations (OR, 7.75 [95% CI, 2.84 to 21.15]; P = 0.0001) and high-level (>8 microg/ml) FQ resistance (OR, 11.0 [95% CI, 2.6 to 47.0]; P = 0.001). The underlying mechanism of the association of the Beijing genotype with high-level FQ resistance in this setting remains to be determined. The association of the Beijing genotype with relatively high-level FQ resistance conferred by specific gyrA mutations reported here is of grave concern given the epidemic spread of the Beijing genotype and the current hopes for shorter first-line treatment regimens based on FQs. |
spellingShingle | Duong, D Nguyen, T Nguyen, T Dai, V Dang, T Vo, S Do, D Nguyen, V Nguyen, H Dinh, N Farrar, J Caws, M Beijing genotype of Mycobacterium tuberculosis is significantly associated with high-level fluoroquinolone resistance in Vietnam. |
title | Beijing genotype of Mycobacterium tuberculosis is significantly associated with high-level fluoroquinolone resistance in Vietnam. |
title_full | Beijing genotype of Mycobacterium tuberculosis is significantly associated with high-level fluoroquinolone resistance in Vietnam. |
title_fullStr | Beijing genotype of Mycobacterium tuberculosis is significantly associated with high-level fluoroquinolone resistance in Vietnam. |
title_full_unstemmed | Beijing genotype of Mycobacterium tuberculosis is significantly associated with high-level fluoroquinolone resistance in Vietnam. |
title_short | Beijing genotype of Mycobacterium tuberculosis is significantly associated with high-level fluoroquinolone resistance in Vietnam. |
title_sort | beijing genotype of mycobacterium tuberculosis is significantly associated with high level fluoroquinolone resistance in vietnam |
work_keys_str_mv | AT duongd beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT nguyent beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT nguyent beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT daiv beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT dangt beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT vos beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT dod beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT nguyenv beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT nguyenh beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT dinhn beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT farrarj beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam AT cawsm beijinggenotypeofmycobacteriumtuberculosisissignificantlyassociatedwithhighlevelfluoroquinoloneresistanceinvietnam |