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

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

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Abstract Molecular methods detect genetic mutations associated with drug resistance.This study detected resistance-conferring mutations in gyrA/gyrB for fluoroquinolones and rrs/eis genes for second-line injectable drugs (SLIDs) among multidrug-resistant Mycobacterium tuberculosis (MDR-TB) isolates in Kuwait.Fifty pansusceptible M.

tuberculosis and 102 MDR-TB Shafts strains were tested.Phenotypic susceptibility testing was performed by MGIT 960 system using SIRE drug kit.GenoType MTBDRsl version 1 (gMTBDRslv1) and GenoType MTBDRsl version 2 (gMTBDRslv2) tests were used for mutation detection.

Results were validated by PCR-sequencing of respective genes.Fingerprinting was performed by spoligotyping.No mutations were detected in pansusceptible isolates.

gMTBDRslv1 detected gyrA mutations in 12 and rrs mutations in 8 MDR-TB isolates.gMTBDRsl2 additionally detected gyrB mutations in 2 and eis mutation in 1 isolate.Mutations in both gyrA/gyrB and rrs/eis were not detected.

gMTBDRslv1 also detected ethambutol resistance-conferring embB mutations Lamp Fragrance in 59 isolates.Although XDR-TB was not detected, frequency of resistance-conferring mutations for fluoroquinolones or SLIDs was significantly higher among isolates collected during 2013–2019 versus 2006–2012.Application of both tests is warranted for proper management of MDR-TB patients in Kuwait as gMTBDRslv2 detected resistance to fluoroquinolones and/or SLIDs in 3 additional isolates while gMTBDRslv1 additionally detected resistance to ethambutol in 58% of MDR-TB isolates.