title: Prevalence and transmission of pyrazinamide resistant Mycobacterium tuberculosis in China.
abstract: Pyrazinamide (PZA) is an important first-line anti-tuberculosis drug, however, there are relatively few available data on PZA resistant (PZA-R) rate in China. From June 2009 to June 2012, we selected 493 isolates from five field settings in China to investigate PZA-R by pncA gene sequencing. The result showed that PZA-R rate was 1.0% (2/196) among pan-susceptible isolates, 3.1% (4/130) among isoniazid (INH) mono-resistant isolates, 14.0% (6/43) among rifampin (RIF) mono-resistant isolates and 43.5% (54/124) among multidrug resistant (MDR) isolates. MDR tuberculosis (TB), RIF mono-resistance, and retreatment were found to be risk factors for PZA-R. Newly diagnosed PZA-R TB patients and clustered isolates with identical pncA mutations indicate that transmission of PZA-R isolates plays an important role in emergence of PZA-R TB. The results suggest that, it is necessary to conduct PZA susceptibility test among MDR isolates and modify the treatment regimens accordingly.
authors.affiliation: Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Institute of Biomedical Sciences, Institute of Medical Microbiology, Shanghai Medical College, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Xu
authors.affiliation: Department of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhong Shan Road, Shanghai 200336, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Wu
authors.affiliation: Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Institute of Biomedical Sciences, Institute of Medical Microbiology, Shanghai Medical College, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China.
authors.forename: Chongguang
authors.initials: C
authors.lastname: Yang
authors.affiliation: Laboratory of Infection and Immunity, School of Basic Medical Science, West China Center of Medical Sciences, Sichuan University, Chengdu, Sichuan 610041, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Luo
authors.affiliation: Department of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhong Shan Road, Shanghai 200336, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhong Shan Road, Shanghai 200336, China.
authors.forename: Yangyi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Institute of Biomedical Sciences, Institute of Medical Microbiology, Shanghai Medical College, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China.
authors.forename: Chijioke A
authors.initials: CA
authors.lastname: Nsofor
authors.affiliation: Department of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhong Shan Road, Shanghai 200336, China. Electronic address: zhugf2014@126.com.
authors.forename: Guofeng
authors.initials: G
authors.lastname: Zhu
authors.affiliation: Emerging Bacterial Pathogens Unit, Institut Pasteur of Shanghai, 411 Hefei Road, Shanghai 200025, China; Unité de Génétique Mycobactérienne, Institut Pasteur, 28 rue du Dr. Roux, 75015 Paris, France. Electronic address: bgicquel@pasteur.fr.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Gicquel
authors.affiliation: Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Institute of Biomedical Sciences, Institute of Medical Microbiology, Shanghai Medical College, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China. Electronic address: qiangao@fudan.edu.cn.
authors.forename: Qian
authors.initials: Q
authors.lastname: Gao
mesh_terms: D000328:Adult; D000581:Amidohydrolases / Q000235:genetics; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D004252:DNA Mutational Analysis; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009154:Mutation; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics / Q000472:pathogenicity*; D010641:Phenotype; D015995:Prevalence; D011718:Pyrazinamide / Q000009:adverse effects / Q000627:therapeutic use*; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission*
chemical_list: D000995:Antitubercular Agents; D011718:Pyrazinamide; D000581:Amidohydrolases; C487496:PncA protein, Mycobacterium tuberculosis
keywords: Mycobacterium tuberculosis; Pyrazinamide resistance; Transmission