title: Co-occurrence of amikacin-resistant and -susceptible Mycobacterium tuberculosis isolates in clinical samples from Beijing, China.
abstract: OBJECTIVE
  This study examined the phenomenon of heteroresistance in Mycobacterium tuberculosis clinical isolates obtained from retreated patients in Beijing, China between 2006 and 2011.
  
  
  METHODS
  The iPLEX Gold assay platform was used to determine the prevalence of heteroresistance to injectable second-line drugs (amikacin, kanamycin and capreomycin) in resistant isolates.
  
  
  RESULTS
  Heteroresistance was identified in 10.9% of 220 phenotypic amikacin-resistant isolates.
  
  
  CONCLUSIONS
  Heteroresistance was related mainly to the short duration and repeated use of amikacin and capreomycin during retreatment. These findings further our understanding of the evolution of resistance to injectable drugs used for tuberculosis treatment and help guide the rational use of injectable drugs during therapy.
authors.affiliation: MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100176, China.
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Zhang
authors.forename: Bing
authors.initials: B
authors.lastname: Zhao
authors.forename: Hairong
authors.initials: H
authors.lastname: Huang
authors.forename: Yafang
authors.initials: Y
authors.lastname: Zhu
authors.forename: Junping
authors.initials: J
authors.lastname: Peng
authors.forename: Guangming
authors.initials: G
authors.lastname: Dai
authors.forename: Guanglu
authors.initials: G
authors.lastname: Jiang
authors.forename: Liguo
authors.initials: L
authors.lastname: Liu
authors.forename: Yanlin
authors.initials: Y
authors.lastname: Zhao
authors.forename: Qi
authors.initials: Q
authors.lastname: Jin
mesh_terms: D000583:Amikacin / Q000494:pharmacology*; D000995:Antitubercular Agents / Q000494:pharmacology*; D002681:China; D024881:Drug Resistance, Bacterial; D005838:Genotype; D006801:Humans; D058889:Molecular Typing; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D010641:Phenotype; D014376:Tuberculosis / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents; D000583:Amikacin
keywords: MDR-TB; aminoglycoside antibiotics; heteroresistance; molecular typing