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Mechanisms of Resistance

Screening and Characterization of Mutations in Isoniazid-Resistant Mycobacterium tuberculosis Isolates Obtained in Brazil

Rosilene Fressatti Cardoso, Robert C. Cooksey, Glenn P. Morlock, Patricia Barco, Leticia Cecon, Francisco Forestiero, Clarice Q. F. Leite, Daisy N. Sato, Maria de Lourdes Shikama, Elsa M. Mamizuka, Rosario D. C. Hirata, Mario H. Hirata
Rosilene Fressatti Cardoso
1Department of Clinical Analysis, State University of Maringá, Paraná
2University of São Paulo, São Paulo, Brazil
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Robert C. Cooksey
3Division of AIDS, STD, and TB Laboratory Research, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Glenn P. Morlock
3Division of AIDS, STD, and TB Laboratory Research, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • For correspondence: gmorlock@cdc.gov
Patricia Barco
2University of São Paulo, São Paulo, Brazil
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Leticia Cecon
2University of São Paulo, São Paulo, Brazil
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Francisco Forestiero
2University of São Paulo, São Paulo, Brazil
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Clarice Q. F. Leite
4Department of Biologic Sciences, Paulista State University, Paulista
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Daisy N. Sato
5Institute Adolfo Lutz, Ribeirão Preto
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Maria de Lourdes Shikama
6Institute Adolfo Lutz, Sorocaba
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Elsa M. Mamizuka
2University of São Paulo, São Paulo, Brazil
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Rosario D. C. Hirata
2University of São Paulo, São Paulo, Brazil
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Mario H. Hirata
2University of São Paulo, São Paulo, Brazil
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DOI: 10.1128/AAC.48.9.3373-3381.2004
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    FIG. 1.

    SSCP analysis of katG315, inhA (promoter and structural ORFs), oxyR-ahpC intergenic region, and three regions of kasA in INH-resistant M. tuberculosis. All PCR products were denatured in the presence of 95% deionized formamide and electrophoresed by using specific conditions shown in Table 2 and by using a GenePhor electrophoresis system (Amersham Biosciences). (A) katG315 (145-bp PCR products). Lanes: 3 and 10, wild-type control (H37Rv); 1, W341S; 2, S315R; 4 and 6, S315N; 7, S315G; 5 and 8, wild type (susceptible isolates); and 9, S315T. (B) inhA promoter (187-bp PCR products). Lanes: 1, wild-type control (H37Rv); 2 and 4, C-17T; 3, C-15T. (C) inhA structural gene (codon 16) (222-bp PCR products). Lanes: 1 and 6, wild-type control (H37Rv); 2, I21V; 3, wild type (susceptible isolate); 4, L44L; 5, I21T. (D) oxyR-ahpC intergenic region (264-bp PCR products). Lanes: 1, 7, and 13, wild-type control (H37Rv); 2, oxyR; 5, C−15T; 6, C−39T; 8, C−10T; 9, G−48A; 10, C−12T; 11, G-9A; 12, C-39T; 3, and 4, wild-type (susceptible isolates). (E) kasA region 3 (269-bp PCR products). Lanes: 1, wild-type control (H37Rv); 2, 4, and 5, H180H; 3, G149G; and 6, wild type (susceptible isolates). (F) kasA region 4 (263-bp PCR products). Lanes: 1, wild-type control (H37Rv); 2 and 3, G269S. (G) kasA region 5 (223-bp PCR products). Lanes: 1, wild-type control (H37Rv); 2, G318G; and 3, wild type (susceptible isolates).

Tables

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  • TABLE 1.

    Oligonucleotide primers used for PCR-SSCP analyses of katG, inhA (regulatory and structural regions), kasA, and the oxyR-ahpC intergenic region

    Accession no.PrimerPrimer sequence (5′ to 3′)Nucleotide locationaPCR annealing temp (°C)PCR product size (bp)
    Z97193 katG-315FAGA GCT CGT ATG GCA CCG GA3205958145
    katG-315RCCA GCA GGG CTC TTC GTC AG31915
    katG-463FCTG CTG TGG CAG GAT CCG GT3163660162
    katG-463RGCG CTT GTC GCT ACC ACG GA31494
    V66801 inhA-1FGCT GAG TCA CAC CGA CAA ACG90960187
    inhA-1RCCA GGA CTG AAC GGG ATA CGA1075
    V02492 inhA-16FTGA CAC AAC ACA AGG ACG CA177952222
    inhA-16RGTT TTG CAC GTC GAG TTC GA1981
    AF106077 inhA-94FGCA AAA CGA GGA GCA CCT GGC199463182
    inhA-94RAAT ACG CCG AGA TGT GGA TGC2156
    V16243 ahpC-FCTT GCG GCA CTG CTG AAC CAC714760264
    ahpC-RACA GGT CAC CGC CGA TGA GAG7389
    Z70692 kasA-1FAAC GTT CAG GCG AGG CTT GA3063168262
    kasA-1RATG TCG AGT CGG CCC ATG TG30873
    kasA-2FCGG TCA CCT CAA GGA TCC GG3084458267
    kasA-2RGCA CCG TTG GGC ATG ATC AT31092
    kasA-3FGGA AGG TGT CCC CGC TGG CC3106663269
    kasA-3RTCA GGC TCG TCG TTG CGG GT31314
    kasA-4FTTC TCC ATG ATG CGG GCC AT3129068263
    kasA-4RAGC TCC AGC GAG CGA GTC AT31533
    kasA-5FCCG ATG GTG TTC GTG CCG GT3150763223
    kasA-5RACC GAC TCG AGC GCA CCG AC31710
    kasA-6FGTC TGC GTC GGG CCA CTC GA3168263255
    kasA-6RCTC GCG GCG ACC CGC GAT GTC31917
    • ↵ a Numbers refer to the nucleotide position within the referenced GenBank sequence of the 5′ primer terminus.

  • TABLE 2.

    Conditions used for SSCP electrophoresisa

    Primer pair(s) (forward/reverse)VoltsTemp (°C)
    katG-315F/315R35012
    katG-463F/463R4008
    inhA-F/1R35012
    inhA-16/17R35012
    inhA-94/94R40012
    ahpC-F/ahpC R40012
    kasA-F/3R and -5F/5R60013
    kasA-2F/2R and -6F/6R4508
    kasA-1F/1R and -4F/4R50013
    • ↵ a GenePhor electrophoresis system using GeneGel Excel 12.5/24 gel (Amersham Biosciences). All PCR amplicons were run for 2 h under the indicated conditions.

  • TABLE 3.

    Oligonucleotide primers used for PCR and the sequencing reaction of katG, inhA (regulatory and structural), the oxyR-ahpC intergenic region, and kasA

    Accession no.PrimerPrimer sequence (5′ to 3′)Nucleotide locationaPCR annealing temp (°C)PCR product size (bp)
    U41314 BC 48TGG CCG CGG CGG TCG ACA TT72558322
    BC 51RCCA GCA GGG CTC TTC GTC AG1027
    Z79701 InhA-1CCT CGC TGC CCA GAA AGG GA87060248
    InhA-2ATC CCC CGG TTT CCT CCG GT1098
    InhA-5TGG ACG GCA AAC GGA TTC TGG181360366
    InhA-6ACG AAT ACG CCG AGA TGT GGA2158
    Z81451 AhpC-1GCC TGG GTG TTC GTC ACT GGT745560359
    AhpC-2CGC AAC GTC GAC TGG CTC ATA7117
    Z70692 KasA-1CGT TCA GGC GAG GCT TGA GGC9368700
    KasA-5CAG GCT CGT CGT TGC GGG TC773
    KasA-4TGC CCA TCG CGG CGT TCT CCA73668703
    KasA-8GTC CGA CTC GCC CCC GCA AGC1418
    KasA-2CCA GAC CGG TTC GCC GTT GTT435
    KasA-6CGC CGG CGG ACA TCG ACC AC1024
    KasA-7GCC GTG CCG TGC GCG TTG A1045
    X68081 KatG-1GCC CGA TAA CAC CAA CTC CTG194768680
    KatG-5CAG ATC CCG CTA CCG CTG TA2606
    KatG-2CGC CGA CTA CGG CCA CTA2254
    KatG-3GCC ACG CCA TCC GGA TAA2238
    KatG-4CCT GGC TCG GCG ATG A258668648
    KatG-9CTC GGT GGA TCA GCT TGT ACC3213
    KatG-6CTC GAT GGC ACC GGA ACC2884
    KatG-7CGT CGG GGT GTT CGT CCA TAC2936
    KatG-8GAG GAA TTG GCC GAC GAG TT318268667
    KatG-13TCT CAG GGG CAC TGA GCG TAA3828
    KatG-10CAA GTC GGG TGG GAG GTC AA3482
    KatG-11CTC TTC CAG GGT GCG AAT GAC3527
    KatG-12GCC GAG TAC ATG CTG CTC GAC379460452
    KatG-14CGG CGG GTT GTG GTT GA4229
    • ↵ a Numbers refer to the nucleotide position within the referenced GenBank sequence of the 5′ primer terminus. Oligonucleotides KasA-2, KasA-6, KasA-7, KatG-2, KatG-3, KatG-6, KatG-7, KatG-10, and KatG-11 were used only for sequencing reactions.

  • TABLE 4.

    Mutations found in katG, kasA, inhA, and the ahpC regulatory region in 97 INH-resistant M. tuberculosis isolates

    GeneNo. of isolatesMutationaINH MICs in μg/ml (no. of isolates if >1)Additional mutation(s)
    Nucleotide no.Amino acid
    katG 1A inserted at position 17Frameshift*32
    1T→C at position 271W91R*>32
    1A→G at position 290H97R*8 katG
    1C→T at position 326A109V*16 oxyR-ahpC
    1C→T at position 329A110A*16 katG, inhA P
    1C→T at position 431A144V*1
    2A→G at position 598K200E*8, >32 katG, inhA P, oxyR-ahpC
    1C→G at position 695P232R*32 inhA P
    1G→T at position 761R254L*NG kasA
    1G→T at position 817G273C*>32 oxyR-ahpC
    1G→A at position 836G279D*>32 inhA P, oxyR-ahpC
    1C→G at position 877L293V*16 inhA P
    1G→A at position 895G299S*>32 oxyR-ahpC, kasA
    1A→C at position 904S302R8 oxyR-ahpC
    1A→G at position 943S315G8 inhA P
    1A→C at position 943S315R>32
    49G→C at position 944S315T4 (23), 8 (15), 16 (5), 32 (3), >32 (3) inhA P, kasA, katG
    7G→A at position 944S315N4 (3), 16, >32 (3) inhA P, katG
    1G→T at position 944S315I16
    1C→G at position 945S315R32
    1G→C at position 1022W341S*>32 inhA P
    1G→T at position 1255D419Y*16 inhA P
    2A→C at position 1256D419A*2, 8 InhA P
    1C→A at position 1257D419E*>32 katG, inhA, oxyR-ahpC
    1T insertion at position 1311Frameshift*>32 oxyR-ahpC
    1A insertion at position 1329Frameshift*16 katG
    1C del at position 1339Frameshift*16 katG
    2G→T at position 1388R463L>32 (2) katG
    1G→A at position 1468G490S*16
    1C→T at position 1833L611L4 inhA P
    1Deletion after position 1845NA*>32 oxyR-ahpC, kasA
    1T→G at position 1985L662R*32
    1C deletion at position 2139Frameshift*>32 oxyR-ahpC
    1G→A at position 2176A726T*16 inhA P
    inhA promoter (P)23C→T at position −15NA1, 2 (3), 4, 8 (6), 16 (5), 32, >32 (6) katG, kasA, oxyR-ahpC, inhA
    2G→T at position −17NA16, 32 katG
    inhA structural1A→G at position 61I21V16 katG, kasA
    4T→C at position 62I21T8, 16 (2), >32 InhA P
    1C→T at position 130L44L>32 katG, inhA P, oxyR-ahpC
    oxyR-ahpC 2G→A at position −9NA16, >32 katG
    1C→T at position −10NA>32 katG, kasA
    1C→T at position −12NA>32 katG
    1C→T at position −15NA>32 katG
    4C→T at position −39**NA8, >32 (3) katG, kasA
    1G→A at position −48*NA>32 katG
    ahpC 1T→C at position 30I10I*4
    kasA 13G→A at position 805G269S1, 4 (3), 8 (3), 16 (2), >32 (3), NGb katG, inhA P, oxyR-ahpC, inhA, kasA
    • ↵ a *, novel mutation; **, one isolate had no additional mutation; NA, not applicable.

    • ↵ b NG, no growth.

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Screening and Characterization of Mutations in Isoniazid-Resistant Mycobacterium tuberculosis Isolates Obtained in Brazil
Rosilene Fressatti Cardoso, Robert C. Cooksey, Glenn P. Morlock, Patricia Barco, Leticia Cecon, Francisco Forestiero, Clarice Q. F. Leite, Daisy N. Sato, Maria de Lourdes Shikama, Elsa M. Mamizuka, Rosario D. C. Hirata, Mario H. Hirata
Antimicrobial Agents and Chemotherapy Aug 2004, 48 (9) 3373-3381; DOI: 10.1128/AAC.48.9.3373-3381.2004

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Screening and Characterization of Mutations in Isoniazid-Resistant Mycobacterium tuberculosis Isolates Obtained in Brazil
Rosilene Fressatti Cardoso, Robert C. Cooksey, Glenn P. Morlock, Patricia Barco, Leticia Cecon, Francisco Forestiero, Clarice Q. F. Leite, Daisy N. Sato, Maria de Lourdes Shikama, Elsa M. Mamizuka, Rosario D. C. Hirata, Mario H. Hirata
Antimicrobial Agents and Chemotherapy Aug 2004, 48 (9) 3373-3381; DOI: 10.1128/AAC.48.9.3373-3381.2004
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KEYWORDS

antitubercular agents
isoniazid
mutation
Mycobacterium tuberculosis
tuberculosis

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