title: Genotypic characterization of multi-drug-resistant Mycobacterium tuberculosis isolates in Myanmar.
abstract: The number of multi-drug-resistant tuberculosis (MDR-TB) cases is rising worldwide. As a countermeasure against this situation, the implementation of rapid molecular tests to identify MDR-TB would be effective. To develop such tests, information on the frequency and distribution of mutations associating with phenotypic drug resistance in Mycobacterium tuberculosis is required in each country. During 2010, the common mutations in the rpoB, katG and inhA of 178 phenotypically MDR M. tuberculosis isolates collected by the National Tuberculosis Control Program (NTP) in Myanmar were investigated by DNA sequencing. Mutations affecting the 81-bp rifampicin (RIF) resistance-determining region (RRDR) of the rpoB were identified in 127 of 178 isolates (71.3%). Two of the most frequently affected codons were 531 and 526, with percentages of 48.3% and 14.0% respectively. For isoniazid (INH) resistance, 114 of 178 MDR-TB isolates (64.0%) had mutations in the katG in which a mutation-conferring amino acid substitution at codon 315 from Ser to Thr was the most common. Mutations in the inhA regulatory region were also detected in 20 (11.2%) isolates, with the majority at position -15. Distinct mutation rate and pattern from surrounding countries might suggest that MDR-TB has developed and spread domestically in Myanmar.
authors.affiliation: Immunology Research Division, Department of Medical Research (Lower Myanmar), Yangon, Myanmar.
authors.forename: Khin Saw
authors.initials: KS
authors.lastname: Aye
authors.affiliation: Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Hokkaido University, The Global Station for Zoonosis Control, Sapparo, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Nakajima
authors.affiliation: Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Immunology Research Division, Department of Medical Research (Lower Myanmar), Yangon, Myanmar.
authors.forename: Min Min
authors.initials: MM
authors.lastname: Win
authors.affiliation: Immunology Research Division, Department of Medical Research (Lower Myanmar), Yangon, Myanmar.
authors.forename: Mu Mu
authors.initials: MM
authors.lastname: Shwe
authors.affiliation: Immunology Research Division, Department of Medical Research (Lower Myanmar), Yangon, Myanmar.
authors.forename: Aye Aye
authors.initials: AA
authors.lastname: Win
authors.affiliation: National TB Control Programme, Department of Health, Yangon, Myanmar.
authors.forename: Thandar
authors.initials: T
authors.lastname: Lwin
authors.affiliation: National TB Control Programme, Department of Health, Yangon, Myanmar.
authors.forename: Wint Wint
authors.initials: WW
authors.lastname: Nyunt
authors.affiliation: National TB Control Programme, Department of Health, Yangon, Myanmar.
authors.forename: Ti
authors.initials: T
authors.lastname: Ti
authors.affiliation: Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Hokkaido University, The Global Station for Zoonosis Control, Sapparo, Japan. Electronic address: suzuki@czc.hokudai.ac.jp.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Suzuki
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D012321:DNA-Directed RNA Polymerases / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009154:Mutation / Q000235:genetics; D002052:Myanmar / Q000453:epidemiology; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins; C505805:rpoB protein, Mycobacterium tuberculosis; D012321:DNA-Directed RNA Polymerases
keywords: Isoniazid; Myanmar; Mycobacterium tuberculosis; Resistance; Rifampicin