title: Drug resistance-conferring mutations in Mycobacterium tuberculosis from Madang, Papua New Guinea.
abstract: BACKGROUND
  Monitoring drug resistance in Mycobacterium tuberculosis is essential to curb the spread of tuberculosis (TB). Unfortunately, drug susceptibility testing is currently not available in Papua New Guinea (PNG) and that impairs TB control in this country. We report for the first time M. tuberculosis mutations associated with resistance to first and second-line anti-TB drugs in Madang, PNG. A molecular cluster analysis was performed to identify M. tuberculosis transmission in that region.
  
  
  RESULTS
  Phenotypic drug susceptibility tests showed 15.7% resistance to at least one drug and 5.2% multidrug resistant (MDR) TB. Rifampicin resistant strains had the rpoB mutations D516F, D516Y or S531L; Isoniazid resistant strains had the mutations katG S315T or inhA promoter C15T; Streptomycin resistant strains had the mutations rpsL K43R, K88Q, K88R), rrs A514C or gidB V77G. The molecular cluster analysis indicated evidence for transmission of resistant strain.
  
  
  CONCLUSIONS
  We observed a substantial rate of MDR-TB in the Madang area of PNG associated with mutations in specific genes. A close monitoring of drug resistance is therefore urgently required, particularly in the presence of drug-resistant M. tuberculosis transmission. In the absence of phenotypic drug susceptibility testing in PNG, molecular assays for drug resistance monitoring would be of advantage.
authors.affiliation: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland.
authors.forename: Marie
authors.initials: M
authors.lastname: Ballif
authors.forename: Paul
authors.initials: P
authors.lastname: Harino
authors.forename: Serej
authors.initials: S
authors.lastname: Ley
authors.forename: Mireia
authors.initials: M
authors.lastname: Coscolla
authors.forename: Stefan
authors.initials: S
authors.lastname: Niemann
authors.forename: Robyn
authors.initials: R
authors.lastname: Carter
authors.forename: Christopher
authors.initials: C
authors.lastname: Coulter
authors.forename: Sonia
authors.initials: S
authors.lastname: Borrell
authors.forename: Peter
authors.initials: P
authors.lastname: Siba
authors.forename: Suparat
authors.initials: S
authors.lastname: Phuanukoonnon
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gagneux
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Beck
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D024881:Drug Resistance, Bacterial; D008826:Microbial Sensitivity Tests; D020125:Mutation, Missense; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D010219:Papua New Guinea; D010865:Pilot Projects; D014376:Tuberculosis / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins