Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China.
Background Multidrug-resistant tuberculosis (MDR-TB) poses a serious challenge to TB control. It is of great value to search for drug resistance mutation sites and explore the roles that they play in the diagnosis and prognosis of MDR-TB. Methods We consecutively enrolled MDR-TB patients from five c...
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ftdoajarticles:oai:doaj.org/article:d55739a9df48444c932183b43cfaec44 2023-05-15T15:10:55+02:00 Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China. Qiao Liu Dandan Yang Beibei Qiu Leonardo Martinez Ye Ji Huan Song Zhongqi Li Jianming Wang 2021-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0009068 https://doaj.org/article/d55739a9df48444c932183b43cfaec44 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0009068 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009068 https://doaj.org/article/d55739a9df48444c932183b43cfaec44 PLoS Neglected Tropical Diseases, Vol 15, Iss 1, p e0009068 (2021) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2021 ftdoajarticles https://doi.org/10.1371/journal.pntd.0009068 2022-12-31T05:59:59Z Background Multidrug-resistant tuberculosis (MDR-TB) poses a serious challenge to TB control. It is of great value to search for drug resistance mutation sites and explore the roles that they play in the diagnosis and prognosis of MDR-TB. Methods We consecutively enrolled MDR-TB patients from five cities in Jiangsu Province, China, between January 2013 and December 2014. Drug susceptibility tests of rifampin, isoniazid, ofloxacin, and kanamycin were routinely performed by proportion methods on Lowenstein-Jensen (LJ) medium. Drug resistance-related genes were sequenced, and the consistency of genetic mutations and phenotypic resistance was compared. The association between mutations and treatment outcomes was expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Results Among 87 MDR-TB patients, 71 with treatment outcomes were involved in the analysis. The proportion of successful treatment was 50.7% (36/71). The rpoB gene exhibited the highest mutation rate (93.0%) followed by katG (70.4%), pncA (33.8%), gyrA (29.6%), eis (15.5%), rrs (12.7%), gyrB (9.9%) and rpsA (4.2%). Multivariable analysis demonstrated that patients with pncA gene mutations (adjusted OR: 19.69; 95% CI: 2.43-159.33), advanced age (adjusted OR: 13.53; 95% CI: 1.46-124.95), and nonstandard treatment (adjusted OR: 7.72; 95% CI: 1.35-44.35) had a significantly higher risk of poor treatment outcomes. Conclusions These results suggest that Mycobacterium tuberculosis gene mutations may be related to phenotypic drug susceptibility. The pncA gene mutation along with treatment regimen and age are associated with the treatment outcomes of MDR-TB. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 15 1 e0009068 |
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Directory of Open Access Journals: DOAJ Articles |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Qiao Liu Dandan Yang Beibei Qiu Leonardo Martinez Ye Ji Huan Song Zhongqi Li Jianming Wang Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China. |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Background Multidrug-resistant tuberculosis (MDR-TB) poses a serious challenge to TB control. It is of great value to search for drug resistance mutation sites and explore the roles that they play in the diagnosis and prognosis of MDR-TB. Methods We consecutively enrolled MDR-TB patients from five cities in Jiangsu Province, China, between January 2013 and December 2014. Drug susceptibility tests of rifampin, isoniazid, ofloxacin, and kanamycin were routinely performed by proportion methods on Lowenstein-Jensen (LJ) medium. Drug resistance-related genes were sequenced, and the consistency of genetic mutations and phenotypic resistance was compared. The association between mutations and treatment outcomes was expressed as odds ratios (ORs) and 95% confidence intervals (CIs). Results Among 87 MDR-TB patients, 71 with treatment outcomes were involved in the analysis. The proportion of successful treatment was 50.7% (36/71). The rpoB gene exhibited the highest mutation rate (93.0%) followed by katG (70.4%), pncA (33.8%), gyrA (29.6%), eis (15.5%), rrs (12.7%), gyrB (9.9%) and rpsA (4.2%). Multivariable analysis demonstrated that patients with pncA gene mutations (adjusted OR: 19.69; 95% CI: 2.43-159.33), advanced age (adjusted OR: 13.53; 95% CI: 1.46-124.95), and nonstandard treatment (adjusted OR: 7.72; 95% CI: 1.35-44.35) had a significantly higher risk of poor treatment outcomes. Conclusions These results suggest that Mycobacterium tuberculosis gene mutations may be related to phenotypic drug susceptibility. The pncA gene mutation along with treatment regimen and age are associated with the treatment outcomes of MDR-TB. |
format |
Article in Journal/Newspaper |
author |
Qiao Liu Dandan Yang Beibei Qiu Leonardo Martinez Ye Ji Huan Song Zhongqi Li Jianming Wang |
author_facet |
Qiao Liu Dandan Yang Beibei Qiu Leonardo Martinez Ye Ji Huan Song Zhongqi Li Jianming Wang |
author_sort |
Qiao Liu |
title |
Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China. |
title_short |
Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China. |
title_full |
Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China. |
title_fullStr |
Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China. |
title_full_unstemmed |
Drug resistance gene mutations and treatment outcomes in MDR-TB: A prospective study in Eastern China. |
title_sort |
drug resistance gene mutations and treatment outcomes in mdr-tb: a prospective study in eastern china. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2021 |
url |
https://doi.org/10.1371/journal.pntd.0009068 https://doaj.org/article/d55739a9df48444c932183b43cfaec44 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 15, Iss 1, p e0009068 (2021) |
op_relation |
https://doi.org/10.1371/journal.pntd.0009068 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0009068 https://doaj.org/article/d55739a9df48444c932183b43cfaec44 |
op_doi |
https://doi.org/10.1371/journal.pntd.0009068 |
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PLOS Neglected Tropical Diseases |
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15 |
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e0009068 |
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