title: Phenotypic and genotypic characterization of pyrazinamide resistance among multidrug-resistant Mycobacterium tuberculosis isolates in Zhejiang, China.
abstract: To explore the phenotypic and genotypic characterization of pyrazinamide (PZA) resistance among multidrug-resistant Mycobacterium tuberculosis (MDR-TB) isolates in Zhejiang province, a total of 274 MDR-TB isolates were collected. Drug susceptibility testing and spoligotyping were performed on all clinical isolates. In addition, the mutated features of PZA-resistant loci, including pncA and rpsA, were also analyzed by DNA sequencing. Our results showed that the prevalence of PZA resistance among MDR-TB strains in Zhejiang province was 43.07% and that PZA resistance was associated with concomitant resistance to streptomycin. The majority of PZA-resistant MDR-TB isolates belonged to the Beijing family. Mutations within pncA, not rpsA, constituted the primary mechanism of PZA resistance. Among 118 PZA-resistant isolates, 53 different mutations were observed in pncA, and most of them were point mutations. Compared with the phenotypic data, DNA sequencing of pncA has sensitivity and specificity of 77.97% and 96.79%, respectively. Analysis of pncA provided a robust tool for rapid detection of PZA drug resistance.
authors.affiliation: Zhejiang Prevention and Treatment Center of Tuberculosis, Zhejiang TCM & WM Hospital, Hangzhou, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xia
authors.affiliation: National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention/State Key Laboratory for Infectious Disease Prevention and Control/National Reference Laboratory of Tuberculosis, Beijing, China Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Zhao
authors.affiliation: Shanghai Public Health Clinical Center, Shanghai, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.affiliation: Zhejiang Prevention and Treatment Center of Tuberculosis, Zhejiang TCM & WM Hospital, Hangzhou, China.
authors.forename: Yu-Mei
authors.initials: YM
authors.lastname: Fan
authors.affiliation: Zhejiang Prevention and Treatment Center of Tuberculosis, Zhejiang TCM & WM Hospital, Hangzhou, China.
authors.forename: Yuan-Yuan
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Bei-Bei
authors.initials: BB
authors.lastname: Wu
authors.affiliation: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Zheng-Wei
authors.initials: ZW
authors.lastname: Liu
authors.affiliation: Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Ai-Zhen
authors.initials: AZ
authors.lastname: Pan
authors.affiliation: Zhejiang Prevention and Treatment Center of Tuberculosis, Zhejiang TCM & WM Hospital, Hangzhou, China zhumindoctor@163.com.
authors.forename: Min
authors.initials: M
authors.lastname: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000235:genetics; D002681:China; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics*; D010641:Phenotype; D017354:Point Mutation / Q000235:genetics; D011718:Pyrazinamide / Q000627:therapeutic use*; D017422:Sequence Analysis, DNA / Q000379:methods; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy* / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D011718:Pyrazinamide