DETECTION OF MULTI AND EXTENSIVELY DRUG RESISTANCE OF MYCOBACTERIUM TUBERCULOSIS BY THE DIFFERENT MOLECULAR TEST-SYSTEMS AND BACTEC™ MGIT™ 960

We carried out the investigation of genetic mutations connected with MBT drug resistance to isoniazid (H), rifampicin (R), fluoroquinolones (Fq) and aminoglycosides(Ag) detected by molecular-genetic methods in 85 isolates. The results were compared to microbiological drug susceptibility testing for that drugs performed in BACTEC™ MGIT™ 960 system. The agreement of the results of detection of MDR, MDR and Fq-resistance, MDR and Ag-resistance and XDR of MBT strains by molecular-genetic and microbiological
methods achieved 94,7, 93,3, 93,3 and 97,3%, consequently. The combination of mutations Ser531Leu in rpoB and Ser315Thr in katG genes was detected in 55,3% of MTB cultures. Asp516Tyr in rpoB, leading to the low resistance level was detected in 2 H-resistant MBT cultures. Among mutations in gyrA gene the substitutions in 94th (58,8%) and 90th (15,7%) codons were detected most frequently. Asp94Gly was found out in 60,0% of MTB cultures. Mutations only in gyrB gene were detected in 4,0% of MTB strains. 2% of MBT strains had the substitutions in the both gyrA and gyrB genes simultaneously. Detection of mutations in the promoter region of eis gene revealed 30 (62,5%) kanamycin and amikacin resistant MBT strains in addition to 18 (37,5%) MTB cultures with the substitutions in rrs gene. The rapid detection of the type of mutations in the MBT genes in combination with microbiologic detection of the resistance level for rifampicin, isoniazid, fluoroquinolones and aminoglycosides gives the best information about investigated MBT strains and helps the clinicians to monitor the development of drug resistance.

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