Can &lt;I&gt;inh&lt;/I&gt;A mutation predict ethionamide resistance? [Short communication]

Vadwai, Viral; Ajbani, Kanchan; Jose, Matilde; Vineeth, V P; Nikam, Chaitali; Deshmukh, M. P.; Shetty, Ashwin S.; Soman, Rajeev; Rodrigues, Carlos H M

doi:10.5588/ijtld.12.0511

Cited by 21 publications

(27 citation statements)

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“…11 Information provided by molecular DST would better identify patients who would benefit from ETH ( kat G mutations) and those more likely to respond to high doses of INH, avoiding unnecessary exposure to these drugs. 11,17,18 …”

Section: Discussionmentioning

confidence: 99%

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Detection of katG and inhA mutations to guide isoniazid and ethionamide use for drug-resistant tuberculosis

et al. 2016

int j tuberc lung dis

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SUMMARY BACKGROUND Depending on the presence of mutations that determine isoniazid (INH) susceptibility (katG and inhA), Mycobacterium tuberculosis may be susceptible to high doses of INH or ethionamide (ETH). OBJECTIVE To describe the INH resistance profile and association of katG mutation with previous INH treatment and level of drug resistance based on rapid molecular drug susceptibility testing (DST) in southern Brazil and central Mozambique. DESIGN Descriptive study of 311 isolates from Ribeirão Preto, São Paulo, Brazil (2011–2014) and 155 isolates from Beira, Mozambique (2014–2015). Drug resistance patterns and specific gene mutations were determined using GenoType® MTBDRplus. RESULTS katG gene mutations were detected in 12/22 (54.5%) Brazilian and 32/38 (84.2%) Mozambican isolates. inhA mutations were observed in 9/22 (40.9%) isolates in Brazil and in 4/38 (10.5%) in Mozambique. Both katG and inhA mutations were detected in respectively 1/22 (5%) and 2/38 (5.2%). The difference in the frequency of katG mutations in Brazil and Mozambique was statistically significant (P = 0.04). katG mutations were present in 68.8% (33/48) of patients previously treated with INH and 31.2% (15/48) of patients without previous INH. This difference was not statistically significant (P = 0.223). CONCLUSION INH mutations varied geographically; molecular DST can be used to guide and accelerate decision making in the use of ETH or high doses of INH.

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Section: Discussionmentioning

confidence: 99%

“…However, it is important to be aware of the possibility of cross-resistance between low-level INH resistance and ETH, as reported by Schaaf et al in South Africa 33 and Vadwai et al in India. 18 …”

Section: Discussionmentioning

confidence: 99%

Detection of katG and inhA mutations to guide isoniazid and ethionamide use for drug-resistant tuberculosis

et al. 2016

int j tuberc lung dis

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“…Ramaswamy and Musser, Basso and Blanchard, identified 6 point mutations in inhA gene (Ile16Thr, Ile21Thr, Ile21Val, Ile47Thr, Val78Ala and Ile95Pro) [15,16]. Recently, in an Indian study, Vadwai et al found 21.4% resistance frequency in inhA gene [17]. The other mechanism for the INH resistance is in the protein encoded by ndh locus.…”

Section: Discussionmentioning

confidence: 99%

Development of Sequence Based Molecular Diagnostic Test to Evaluate MDR and XDR in M. tuberculosis Patients from Western India

Potdar¹,

Thakur²

2013

AJIDM

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Globally, Tuberculosis is the most distress disease which remains as a major challenge from the standpoint of diagnosis, detection of drug resistance, and treatment. The increasing knowledge in molecular biology techniques has improved our understanding of the molecular mechanisms of drug resistance for the major first and second-line anti-tubercular drugs. Thus, rapid and accurate diagnosis of Tuberculosis would improve patient care and limit its transmission. This study is aimed to identify mutations in drug resistance genes of first and second line drugs against Mycobacterium tuberculosis by using polymerase chain reaction (PCR) and DNA sequencing methods. This study involves sputum samples of 20 patients diagnosed to have pulmonary tuberculosis. The genomic DNA from clinical isolates was isolated using simple boiling method. PCR amplification and DNA sequencing were performed for katG, inhA, ndh, kasA, pncA, embB, rrs, rpsL, rpoB, gyrA, gyrB and thyA genes. Sequence analysis was done using Bioedit, a bioinformatics tool. The isolates of Mycobacterium tuberculosis from western part of India were analyzed by DNA sequencing revealed total 29 mutations in first line drugs. Out of them, 5(25%) in rpoB at codon 516 and 531, 6(30%) in katG at codon 315, 8(40%) in rpsL at codon 43 & 88, 3(15%) in embB at codon 306 and 7(35%) in pncA at codon 195.No mutations in inhA, ndh, kasA and rrs genes were observed in our study. In the second line drugs, 2(10%) at codon 90 & 100% mutations at codon 95 in gyrA gene, and no mutation in gyrB and thyA genes were observed.

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“…High-dose INH may be effective [29, 30•] in the case of low drug-resistance levelsas in the case of mutations in the inhA gene and not in the KatG gene (both identifiable by GenoType). Mutations in InhA, in fact, confer low levels of resistance to INH and frequently high levels of resistance to thionamides [31]. Rifapentine cannot be recommended, given its complete cross-resistance with rifampicin.…”

Section: Designing a Regimen For Mdr-tbselection Of Drugsmentioning

confidence: 99%

“…Thionamides should be selected first [24,25] because they are more bactericidal, better tolerated, and less expensive than the other group 4 drugs. However, their efficacy is adversely affected by the presence of an inhA mutation [31], which can be detected by GenoType. The next selection should be cycloserines or terizidone, which are bacteriostatic with limited toxicity and no cross-resistance with other compounds.…”

Section: Groupmentioning

confidence: 99%

Management of drug-resistant tuberculosis

Scardigli

Caminero

2013

Curr Respir Care Rep

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The emergence and spread of drug-resistant strains of Mycobacterium tuberculosis (M. tuberculosis) have become tremendous challenges for clinical and programmatic tuberculosis (TB) management. Until recently, TB diagnosis was largely based on 120-year-old smear microscopy, and treatment was based on a limited number of drugs developed prior to 1970. During the past few years, we have witnessed a revolution in the ability of laboratories to detect TB and anti-TB drug resistance. Furthermore, after several years of silence, several new anti-TB drugs have recently appeared on the scene, offering hope for patients with very limited therapeutic options. There is also new evidence supporting the appropriate use of existing drugs in the treatment of MDR-TB and a better understanding of the relevance of additional resistance beyond extensive drug resistance patterns. In this article, we review the management of drug-resistant TB and highlight recent developments concerning its diagnosis and treatment.

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Can <I>inh</I>A mutation predict ethionamide resistance? [Short communication]

Abstract: An inhA promoter mutation could be considered as a marker for the determination of ETH resistance in India, where the use of LPA is being expanded.

Cited by 21 publications

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Detection of <I>kat</I>G and <I>inh</I>A mutations to guide isoniazid and ethionamide use for drug-resistant tuberculosis

Detection of <I>kat</I>G and <I>inh</I>A mutations to guide isoniazid and ethionamide use for drug-resistant tuberculosis

Development of Sequence Based Molecular Diagnostic Test to Evaluate MDR and XDR in <i>M.</i> <i>t</i><i>uberculosis</i> Patients from Western India

Management of drug-resistant tuberculosis

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