1887

Abstract

The phenotypic resistance to ethambutol (EMB) in with gene mutations is still unclear. This study was designed to better understand EMB resistance due to gene mutation. Sequencing analysis of the gene was performed for 124 EMB-susceptible and 93 EMB-resistant strains isolated from South Korea. The MIC was determined for EMB-susceptible strains with the mutation and wild-type on Löwenstein–Jenson (LJ) solid medium in duplicate. Two (2.8 %) of 72 pan-susceptible, two (9.1 %) of 22 any-drug-resistant but EMB-susceptible, nine (30.0 %) of 30 multidrug-resistant (MDR) but EMB-susceptible and 84 (90.3 %) of 93 EMB-resistant strains possessed mutations at various codons including 306, 319, 354, 360, 399, 405, 406, 459 and 497. Strains with mutations at codons 306, 354, 399, 405 and 497 had highly pronounced EMB resistance, while strains with mutations at codons 319 and 406 mutations were moderately resistant and those with an mutation were EMB-susceptible at the critical concentration (2.0 µg ml) on LJ solid medium. However, the mean MIC for strains with mutations (1.42 µg ml) was higher than that for strains without the mutation (1.0 µg ml) in EMB-susceptible isolates ( = 0.0052). Three novel mutations at codons 399, 405 and 459 were identified in this study. These results support the hypothesis that mutation except for a few specific mutation types may be the main cause of EMB resistance.

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2012-04-01
2019-10-19
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