Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Detection of Mutations and Genotyping of Drug-Resistant Mycobacterium Tuberculosis Strains Isolated From Patients in Rural Eastern Cape Province

Version 1 : Received: 5 April 2023 / Approved: 6 April 2023 / Online: 6 April 2023 (09:24:17 CEST)
Version 2 : Received: 4 May 2023 / Approved: 5 May 2023 / Online: 5 May 2023 (07:26:31 CEST)
Version 3 : Received: 8 June 2023 / Approved: 9 June 2023 / Online: 9 June 2023 (15:36:21 CEST)

A peer-reviewed article of this Preprint also exists.

Faye, L.M.; Hosu, M.C.; Oostvogels, S.; Dippenaar, A.; Warren, R.M.; Sineke, N.; Vasaikar, S.; Apalata, T. The Detection of Mutations and Genotyping of Drug-Resistant Mycobacterium tuberculosis Strains Isolated from Patients in the Rural Eastern Cape Province. Infect. Dis. Rep. 2023, 15, 403-416. Faye, L.M.; Hosu, M.C.; Oostvogels, S.; Dippenaar, A.; Warren, R.M.; Sineke, N.; Vasaikar, S.; Apalata, T. The Detection of Mutations and Genotyping of Drug-Resistant Mycobacterium tuberculosis Strains Isolated from Patients in the Rural Eastern Cape Province. Infect. Dis. Rep. 2023, 15, 403-416.

Abstract

Drug-resistant tuberculosis (DR-TB) remains a major public health problem in South Africa. Gene mu-tations and the genotyping of DR-TB in a rural Eastern Cape Province have not previously been studied. Hence, we sought to detect prevalent mutations linked to DR-TB profiles, identify genetic diversity, and assign lineages. Sputum specimens were obtained from 1157 patients suspected with tuberculosis. They were assayed for rifampin-resistance using Xpert® MTB/RIF.and detection of mutations conferring re-sistance to anti-TB drugs was carried out using GenoType MTBDRplus VER 2.0. Thereafter, 441 isolates were spoligotyped. The most prevalent rifampin resistance-conferring mutations were in rpoB codon S531L. The INH resistant strains, 54.5% had mutations in katG gene at codon S315TB and 24.7% with mutations in inhA gene at codons C-15TB. Furthermore 69.9% strains displayed mutations involving both rpoB and katG genes, while 24.6% strains displayed mutations involving both rpoB and inhA genes. The overall prevalence of heteroresistance was 17.9%. Spoligotyping analysis generated 410 patterns of iso-lates which were found in the international database, with Beijing family being predominant. The diversity of mutations in the study provides information for investigating the evolutional lineages of M. tuberculosis isolates. The recognition frequency of rpoB, katG and inhA mutations in different study areas may help to guide decision‑making about standardization of treatment regimens or individualized treatment in areas where these mutations have been found. This calls for increased drug resistance surveillance and rein-forcement of TB control in this area.

Keywords

Drug-resistant TB; Heteroresistance; Mutations; Spoligotyping

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

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