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Mutations in gyrA and gyrB among Drug Resistant Mycobacterium Tuberculosis in Korea
( Hee Joo Lee ),( Hwi-Jun Kim ),( Ryeun Heo ),( Cheon-Tae Kim ),( Hee-Jin Kim ),( Jeong-hui Gwon ),( Gicheon Bae ),( Sumi Kang ),( Soul-hee Kim ),( Seungmo Kim ),( Eunseon Kim ),( Arim Song ),( Dea-Se 대한결핵 및 호흡기학회 2021 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.129 No.0
Purpose In 2020 KATRD, we analyzed 65 isolates to see how gyrA and gyrB are associated with 7H9 broth microdilution method (BMD) and Lowenstein-Jensen (L-J) drug susceptibility test (DST) because fluoroquinolones (FLQ) have been recognized as important anti-TB agents. In this study, the aim is to evaluate the correlation between gyrA and gyrB mutations and resistance to FLQ with BMD and L-J DST as a follow up of the previous study. Method Since 2020, we have analyzed 304 INH or RIF mono resistant cases by molecular DST using sequencing for gyrA and gyrB genes of FLQ. MICs were measured by BMD for moxifloxacin (MFX, 0.0625~8.0 μg/mL) and levofloxacin (LFX, 0.0625~8.0 μg/ mL). In L-J DST, concentration of MFX was 1.0 μg/mL, 2.0 μg/mL and LFX was 2.0 μg/mL. Results In gyrA and gyrB sequencing, 270 strains (88.81%) were wild type (WT), 34 strains (11.18%) were mutant type (MT). Among 29 gyrA MT strains, 13 isolates (44.82%) had mutation at D94G, 7 isolates (24.14%) at A90V and 5 isolates (17.24%) at D94A. Among 5 gyrB MT strains, 2 isolates (40%) had D500N mutation. In L-J DST, 100% of gyrA MT strains were resistant to MFX. On the other hand gyrB MT strains, 60% to MFX and 40% to LFX were resistant. In BMD, 93.10% of gyrA MT strains ranged 0.5 ~ 4.0 μg/mL and 60% of gyrB MT strains ranged 0.5 ~ 4.0 μg/mL to MFX. Meanwhile 96.55% of gyrA MT strains ranged 1.0 ~ 8.0 μg/mL and 80% of gyrB MT strains ranged 1.0 ~ 8.0 μg/mL to LFX. Conclusions Most of the mutant isolates had mutations in gyrA and most of mutant type (38.23%) was gyrA_D94G (GAC/GGC). In this study we observed gyrA genes were associated with higher MICs based on 7H9 and L-J DST than gyrB genes. # No.2021R1F1A1061358