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Antimicrobial Agents and Chemotherapy, February 2008, p. 725-729, Vol. 52, No. 2
0066-4804/08/$08.00+0     doi:10.1128/AAC.01124-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.

Prevalence of and Molecular Basis for Tuberculosis Drug Resistance in the Republic of Georgia: Validation of a QIAplex System for Detection of Drug Resistance-Related Mutations{triangledown}

Medea Gegia,1 Nino Mdivani,1 Rodrigo E. Mendes,3 Haijing Li,4 Maka Akhalaia,2 Jian Han,3 George Khechinashvili,1 and Yi-Wei Tang4,5*

Georgian Foundation against Tuberculosis and Lung Diseases,1 National Center of Tuberculosis and Lung Diseases, Tbilisi, Georgia,2 Genaco Biomedical Products, Inc., Huntsville, Alabama 35805,3 Departments of Medicine,4 Pathology, Vanderbilt University School of Medicine, Nashville, Tennessee 372325

Received 24 August 2007/ Returned for modification 17 October 2007/ Accepted 27 November 2007

We developed a QIAplex system for the simultaneous detection of 24 Mycobacterium tuberculosis gene mutations responsible for resistance to isoniazid (INH), rifampin (RIF), streptomycin (STM), and ethambutol (EMB) in 196 M. tuberculosis isolates recovered in the Republic of Georgia. In comparison to phenotypic susceptibility tests, the QIAplex showed sensitivity and specificity of 85.4% and 96.1% for INH, 94.4% and 99.4% for RIF, 69.6% and 99.2% for STM, 50.0% and 98.8% for EBM, and 86.7% and 100.0% for multidrug resistance, respectively. The dominant resistance mutations revealed were a mutation in katG resulting in S315T (katG S315T), rpsL K43R, and rpoB S531L. Mutations katG S315G and S315T and rpoB S531L were detected with higher frequencies in pretreated patients than in naive patients (P < 0.05). Simultaneous detection of 24 common drug resistance-related mutations provides a molecular tool for studying and monitoring M. tuberculosis resistance mechanism and epidemiology.

* Corresponding author. Mailing address: Molecular Infectious Disease Laboratory, Vanderbilt University Hospital, 4605 TVC, Nashville, TN 37232-5310. Phone: (615) 322-2035. Fax: (615) 343-8420. E-mail: yiwei.tang{at}vanderbilt.edu

{triangledown} Published ahead of print on 10 December 2007.

Antimicrobial Agents and Chemotherapy, February 2008, p. 725-729, Vol. 52, No. 2
0066-4804/08/$08.00+0     doi:10.1128/AAC.01124-07
Copyright © 2008, American Society for Microbiology. All Rights Reserved.





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