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Mutations in gyrA and gyrB Among Drug Resistant Mycobacterium Tuberculosis in Korea
( Seungmo Kim ),( Ryeun Heo ),( Hee Joo Lee ),( Cheon-Tae Kim ),( Hee-Jin Kim ),( Jong-Wook Hong ),( Soul-hee Kim ),( Tae-Shik Park ),( Dea-Seon Han ),( Hyeon-Su Kim ),( Jong-Myun Song ),( Mi-so Kim ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.0
Background Fluoroquinolones have been recognized as important anti-TB agents based on new tuberculosis treatment guidelines. In this study we have evaluated gyrA and gyrB how to relate with MIC based on 7H9 and phenotypic DST Results based on Löwenstein-Jensen (L-J) medium. Method Since 13th July 2020, 108 cases have analyzed gyrA and gyrB genes for fluoroquinolones. We have tested bedaquiline (0.03125~4 μg/mL), delamanid (0.00625~0.8 μg/mL), moxifloxacin (0.0625~8.0 μg/mL), levofloxacin (0.0625~8.0 μg/mL), linezolid (0.0625~8.0 μg/mL) using 7H9 broth. In Löwenstein-Jensen (L-J)medium, low concentration of moxifloxacin was 1.0 μg/mL and high concentration of moxifloxacin was 2.0 μg/mL, And that of levofloxacin and linezolid was 2.0μg/mL. Results All of mono-INH resistant cases analyzed wild type in gyrA and gyrB genes. There were 7 mutant type analyzed in gyrA and 1 mutant type in gyrB gene among 54 RIF resistant and MDR cases. All of 8 cases what we analyzed mutant type in gyrA and gyrB genes was interpreted resistant in phenotypic DST using L-J medium. Additionally all of 52 cases interpreted susceptible in phenotypic DST using L-J medium was wild type in gyrA and gyrB genes. The distribution of MICs for moxifloxacin what analyzed mutant type in gyrA gene was middle and high level (1.0 ~ 4.0 μg/mL). And The MIC for moxifloxacin what analyzed mutant type in gyrB gene was middle level (0.5 μg/mL). The distribution of MICs for levofloxacin what analyzed mutant type in gyrA gene was high level (4.0 ~ 8.0 μg/mL). And The MIC for levofloxacin what analyzed mutant type in gyrB gene was middle level (1.0 μg/mL). Conclusions We found 8 mutant type cases in gyrA and gyrB genes. Most of mutant type (75%) was gyrA_D94G(GAC/GGC). We observed gyrA and gyrB genes were associated with MICs based on 7H9 and phenotypic DST Results based on L-J medium.