Open Access Highly Accessed Research article

Characterization of extensively drug-resistant Mycobacterium tuberculosis isolates circulating in Siberia

Maya A Dymova12*, Andrey G Cherednichenko3, Olga I Alkhovik3, Eugeny A Khrapov1, Tatjana I Petrenko3 and Maxim L Filipenko12

Author Affiliations

1 Institute of Chemical Biology and Fundamental Medicine (ICBFM), Siberian Branch of The Russian Academy of Sciences (SB RAS), Novosibirsk, Russia

2 Novosibirsk State University (NSU), Novosibirsk, Russia

3 Ministry of Public Health and Social Development of The Russian Federation (NRIT), Novosibirsk Research Institute of Tuberculosis, Novosibirsk, Russia

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BMC Infectious Diseases 2014, 14:478  doi:10.1186/1471-2334-14-478

Published: 3 September 2014

Abstract

Background

The spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) Mycobacterium tuberculosis compromises effective control of tuberculosis (TB) in Siberia. Early identification of drug-resistant isolates is, therefore, crucial for effective treatment of this disease. The aim of this study was to conduct drug susceptibility testing and identify mutations in drug resistance genes in clinical isolates of M. tuberculosis from some TB patients presenting for treatment in Siberia.

Methods

Thirty randomly selected clinical isolates of M. tuberculosis were obtained from the Novosibirsk Research Institute of Tuberculosis, Russia. Isolates were screened for drug resistance and characterized by variable number of tandem repeats (VNTR)-typing using 15 standard and four additional loci. Deligotyping on multiple large sequences was performed using 10 loci.

Results

Twenty-nine of the isolates were assigned XDR status. Twenty-eight isolates belonged to the M. tuberculosis Beijing family, from which 11 isolates were considered the M11 type (39%), two the M2 type (7%), and one the M33 type (3%). Seventeen isolates (60.7%) from this family exhibited unique genetic patterns. The remaining two isolates belonged to the Latino-American Mediterranean family. Gene sequences (rpoB, katG, rrs, rpsL, tlyA, gidB, gyrA, gyrB) were analyzed to identify mutations that confer resistance to rifampicin, isoniazid, amikacin, kanamycin, capreomycin, and ofloxacin. The most common mutations among the XDR isolates were S531L in RpoB, S315T in KatG, various codon 94 mutations in gyrA, A90V in GyrA, K43R in RpsL, and 1401 A → G in rrs; these confer resistance to rifampicin, isoniazid, ofloxacin, streptomycin and kanamycin/capreomycin, respectively. There was high congruence between the two typing methods (VNTR typing and deligotyping) and RD105, RD149, RD152, RD181, and RD207 regions of difference were absent from the 28 Beijing family isolates.

Conclusions

Deligotyping can be used for rapid and reliable screening of M. tuberculosis isolates, followed by more in-depth genotyping. Identification of Beijing family isolates with extensive drug resistance confirms that such strains have epidemiological importance in Siberia. Rapid detection of mutations that lead to drug resistance should facilitate selection of effective drug therapies, and the development of early prevention strategies to combat this infection.

Keywords:
Mycobacterium tuberculosis; Multidrug resistance; Drug-resistance mutations; Genotyping