Role of
            <i>rpsA</i>
            Gene Sequencing in Diagnosis of Pyrazinamide Resistance

Simons, Sami O.; Mulder, A.; Ingen, Jakko van; Boeree, Martin J.; Soolingen, Dick van

doi:10.1128/jcm.02739-12

Cited by 42 publications

(29 citation statements)

References 3 publications

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“…Also, recently, two new genes (RpsA and panD) that might be implicated in PZA resistance have been identified (16)(17)(18). The RpsA gene codes for a vital ribosomal protein involved in trans-translation (16)(17)(18). Trans-translation is involved in degradation of potentially toxic …”

Section: Discussionmentioning

confidence: 99%

Improved Detection by Next-Generation Sequencing of Pyrazinamide Resistance in Mycobacterium tuberculosis Isolates

Maningi

Daum²,

Rodriguez³

et al. 2015

J Clin Microbiol

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eThe technical limitations of common tests used for detecting pyrazinamide (PZA) resistance in Mycobacterium tuberculosis isolates pose challenges for comprehensive and accurate descriptions of drug resistance in patients with multidrug-resistant tuberculosis (MDR-TB). In this study, a 606-bp fragment (comprising the pncA coding region plus the promoter) was sequenced using Ion Torrent next-generation sequencing (NGS) to detect associated PZA resistance mutations in 88 recultured MDR-TB isolates from an archived series collected in 2001. These 88 isolates were previously Sanger sequenced, with 55 (61%) designated as carrying the wild-type pncA gene and 33 (37%) showing mutations. PZA susceptibility of the isolates was also determined using the Bactec 460 TB system and the Wayne test. In this study, isolates were recultured and susceptibility testing was performed in Bactec 960 MGIT. Concordance between NGS and MGIT results was 93% (n ‫؍‬ 88), and concordance values between the Bactec 460, the Wayne test, or pncA gene Sanger sequencing and NGS results were 82% (n ‫؍‬ 88), 83% (n ‫؍‬ 88), and 89% (n ‫؍‬ 88), respectively. NGS confirmed the majority of pncA mutations detected by Sanger sequencing but revealed several new and mixed-strain mutations that resolved discordancy in other phenotypic results. Importantly, in 53% (18/34) of these isolates, pncA mutations were located in the 151 to 360 region and warrant further exploration. In these isolates, with their known resistance to rifampin, NGS of pncA improved PZA resistance detection sensitivity to 97% and specificity to 94% using NGS as the gold standard and helped to resolve discordant results from conventional methodologies. P yrazinamide (PZA) is a cornerstone first-line antituberculosis compound that is also commonly used in the second-line therapeutic treatment of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) infection in humans. The drug is a structural analogue of nicotinamide, requiring conversion into its active form, i.e., pyrazinoic acid, by the enzyme pyrazinamidase/nicotinamidase (PZase) (1, 2). PZase is encoded by the M. tuberculosis pncA gene (561 bp) (2). It has been postulated that the mechanism of action of PZA is through pyrazinoic acid, causing disruption of bacterial membrane-mediated energetics and ultimately causing inhibition of membrane transport (3). The contribution of PZA to the killing of M. tuberculosis as part of a multidrug regimen for the treatment of tuberculosis (TB) is considerable, and its inclusion with rifampin in anti-TB therapeutic regimens has resulted in the significant shortening of treatment duration from 18 to 6 months (3). The drug is known to specifically target semidormant bacteria that are not killed by other antituberculosis drugs (4, 5).Mutations in the pncA gene are associated with phenotypically pyrazinamide-resistant isolates of M. tuberculosis (2, 6, 7). Such mutations can occur in the promoter or coding regions and result in amino acid substitutions, frameshifts, or stop codon mutations. Furtherm...

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Section: Discussionmentioning

confidence: 99%

Improved Detection by Next-Generation Sequencing of Pyrazinamide Resistance in Mycobacterium tuberculosis Isolates

Maningi

Daum²,

Rodriguez³

et al. 2015

J Clin Microbiol

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“…In addition, the rpsA gene plus FR is long and not very convenient for amplification and sequencing, so the authors concluded that analysis of the rpsA gene had no role in the detection of pyrazinamide resistance (7). This suggestion was further supported by Simons and colleagues, who reported that only 1 of 5 PZA-resistant isolates with pncA WT had an RpsA (V260I) mutation (34) and that this so-called mutation was even questionable based on the disparity of the reported mutated codon and the amino acid that it encoded. However, in the current study, 3 of 7 phenotypically PZA r but genotypically pncA WT ϩ FR WT isolates had rpsA mutations which were all clustered in the C terminus of RpsA protein (3= of rpsA gene).…”

mentioning

confidence: 86%

Role of pncA and rpsA Gene Sequencing in Detection of Pyrazinamide Resistance in Mycobacterium tuberculosis Isolates from Southern China

Tan

Zhang

et al. 2014

J Clin Microbiol

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“…Recently, S1 ribosomal protein (RpsA) was identified as a molecular target for POA [8]. Mutations in rpsA gene were found in some PZA-resistant M. tuberculosis isolates lacking mutations in pncA [8,9]. RpsA is a key protein of trans-translation, a mechanism for saving stalled ribosomes or damaged mRNA, essential for dormant and persister cells [10,11].…”

Section: Introductionmentioning

confidence: 99%

Resistance to pyrazinamide in Russian Mycobacterium tuberculosis isolates: pncA sequencing versus Bactec MGIT 960

et al. 2015

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Role of rpsA Gene Sequencing in Diagnosis of Pyrazinamide Resistance

Cited by 42 publications

References 3 publications

Improved Detection by Next-Generation Sequencing of Pyrazinamide Resistance in Mycobacterium tuberculosis Isolates

Improved Detection by Next-Generation Sequencing of Pyrazinamide Resistance in Mycobacterium tuberculosis Isolates

Role of pncA and rpsA Gene Sequencing in Detection of Pyrazinamide Resistance in Mycobacterium tuberculosis Isolates from Southern China

Resistance to pyrazinamide in Russian Mycobacterium tuberculosis isolates: pncA sequencing versus Bactec MGIT 960

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