Drug-resistant Mycobacterium tuberculosis: Epidemiology and role of morphological alterations

2018 ◽  
Vol 12 ◽  
pp. 192-196 ◽  
Author(s):  
Ali Akbar Velayati ◽  
Parissa Farnia ◽  
Sven Hoffner
2005 ◽  
Vol 49 (9) ◽  
pp. 3794-3802 ◽  
Author(s):  
Manzour Hernando Hazbón ◽  
Miriam Bobadilla del Valle ◽  
Marta Inírida Guerrero ◽  
Mandira Varma-Basil ◽  
Ingrid Filliol ◽  
...  

ABSTRACT Mutations at position 306 of embB (embB306) have been proposed as a marker for ethambutol resistance in Mycobacterium tuberculosis; however, recent reports of embB306 mutations in ethambutol-susceptible isolates caused us to question the biological role of this mutation. We tested 1,020 clinical M. tuberculosis isolates with different drug susceptibility patterns and of different geographical origins for associations between embB306 mutations, drug resistance patterns, and major genetic group. One hundred isolates (10%) contained a mutation in embB306; however, only 55 of these mutants were ethambutol resistant. Mutations in embB306 could not be uniquely associated with any particular type of drug resistance and were found in all three major genetic groups. A striking association was observed between these mutations and resistance to any drug (P < 0.001), and the association between embB306 mutations and resistance to increasing numbers of drugs was highly significant (P < 0.001 for trend). We examined the association between embB306 mutations and IS6110 clustering (as a proxy for transmission) among all drug-resistant isolates. Mutations in embB306 were significantly associated with clustering by univariate analysis (odds ratio, 2.44; P = 0.004). In a multivariate model that also included mutations in katG315, katG463, gyrA95, and kasA269, only mutations in embB306 (odds ratio, 2.14; P = 0.008) and katG315 (odds ratio, 1.99; P = 0.015) were found to be independently associated with clustering. In conclusion, embB306 mutations do not cause classical ethambutol resistance but may predispose M. tuberculosis isolates to the development of resistance to increasing numbers of antibiotics and may increase the ability of drug-resistant isolates to be transmitted between subjects.


eLife ◽  
2017 ◽  
Vol 6 ◽  
Author(s):  
Saurabh Mishra ◽  
Prashant Shukla ◽  
Ashima Bhaskar ◽  
Kushi Anand ◽  
Priyanka Baloni ◽  
...  

Mycobacterium tuberculosis (Mtb) expresses a broad-spectrum β-lactamase (BlaC) that mediates resistance to one of the highly effective antibacterials, β-lactams. Nonetheless, β-lactams showed mycobactericidal activity in combination with β-lactamase inhibitor, clavulanate (Clav). However, the mechanistic aspects of how Mtb responds to β-lactams such as Amoxicillin in combination with Clav (referred as Augmentin [AG]) are not clear. Here, we identified cytoplasmic redox potential and intracellular redox sensor, WhiB4, as key determinants of mycobacterial resistance against AG. Using computer-based, biochemical, redox-biosensor, and genetic strategies, we uncovered a functional linkage between specific determinants of β-lactam resistance (e.g. β-lactamase) and redox potential in Mtb. We also describe the role of WhiB4 in coordinating the activity of β-lactamase in a redox-dependent manner to tolerate AG. Disruption of WhiB4 enhances AG tolerance, whereas overexpression potentiates AG activity against drug-resistant Mtb. Our findings suggest that AG can be exploited to diminish drug-resistance in Mtb through redox-based interventions.


Author(s):  
Somanna Nachappa ◽  
Sumana Neelambike ◽  
Ahmad Sarikhani ◽  
Nallur Ramachandra

: A molecular method for diagnosis of drug-resistant Tuberculosis is Multiplex allele-specific PCR (MAS-PCR), which is more time-efficient. Also, understanding the role of mutations when translated to protein, in causing resistance helps better drug designing. Aims: To study MAS-PCR in the detection of drug resistance in comparison to DNA sequencing, and understand the mechanism of interaction of drugs with mutant proteins in Mycobacterium tuberculosis. Methods: Detection of drug-resistant mutations using MAS-PCR and validation through DNA sequencing. MAS-PCR targeted four genes, iniA for the drug Ethambutol, rpsL and rrs for Streptomycin, and gyrA for Fluoroquinolone resistance, respectively. Further, the sequence data was analysed and modelled to study the effect on interaction of the anti-TB drug molecule with the target protein using in silico docking. Results: We identified drug-resistant mutations in four out of 95 isolates with one of them carrying a mutation at codon iniA501, two at gyrA94, and one for both iniA501 and gyrA94 using MAS-PCR. DNA sequencing confirmed drug-resistant mutations in only two isolates, whereas two others had mutation adjacent to the target allele. Molecular docking showed Estimated Free Energy of Binding (ΔG) being higher for Fluoroquinolone binding with GyrA D94V mutant. Both, wild and mutant IniA interact with EMB but had no significant effect on binding energy. Conclusions: DNA sequencing-based drug resistance detection of TB is more accurate than MAS-PCR. Understanding the role of mutations in influencing the drug-protein interaction will help in designing effective drug alternatives.


1970 ◽  
Vol 7 (2) ◽  
pp. 26-29
Author(s):  
NK Jain ◽  
A Bajpai ◽  
S Avashia ◽  
PK Gupta

Background: Tubercular empyema is one of the commonest chronic diseases in the developing countries of the world including India. As the problem of drug resistant strain of tubercular bacilli is increasing, new modalities of treatment that could act against resistant strain are needed. Objective: The purpose of this study was to evaluate the efficacy of low- level nitrogen laser therapy (LLLT) as an adjuvant to anti-tubercular treatment in case of tubercular empyema that was not responding to conventional anti-tuberculosis drugs and repeated pus aspiration. Patient: The patient, a 19 year old male was diagnosed with tubercular empyema. He was not improving by conventional treatment and pus aspiration. The patient was administered intralesional nitrogen laser (337 nanometer, average power 5 mW) for 780 seconds at intervals of 72 hours up to 10 weeks. Results: After the fifth laser irradiation session, decrease in chest pain was reported and pus mixed with blood pleural fluid aspirated. After the tenth laser irradiation session, serous pleural fluid was aspirated. After 20 sessions of laser irradiation the empyema was healed completely and the patient also regained almost complete expansion of lung. Conclusion: LLLT was observed to results in the healing of the tubercular empyema and also found to make the empyema free of Mycobacterium tuberculosis. However, further randomized studies with more patients are needed to prove the efficacy of this method. Key words: Mycobacterium tuberculosis; empyema; laser  DOI: 10.3126/saarctb.v7i2.4402SAARC J. TUBER. LUNG DIS. HIV/AIDS 2010 VII(2) 26-29


2018 ◽  
Author(s):  
Xinxin Yang ◽  
Tianao Yuan ◽  
Rui Ma ◽  
Scott Franzblau ◽  
Nicole Sampson

Cholesterol is important for <i>Mycobacterium tuberculosis (Mtb)</i> survival and persistence in the host. We describe a series of 6-azasteroids tested as cholesterol analogs, that are synergistic inhibitors of <i>Mtb</i> viability. The analogs improve <i>Mtb</i> killing efficacy by isoniaizid and bedaquiline, two approved drugs for the treatment of drug-sensitive and drug-resistant <i>Mtb</i>, respectively. In addition, the 6-azasteroids work with existing TB drugs under anaerobic conditions and lower their MICs by greater than 10-fold, suggesting they will work in hypoxic conditions found in infected lungs. <div><br><div>Our work provides strong evidence for an expanded repertoire of cholesterol utilization in <i>Mtb</i> infection that extends beyond the commonly accepted role of cholesterol in nutrition and primary energy generation. We discovered that a stress-resistance regulon (Mce3R) is required for the synergistic activity of 6-azasteroids. Moreover, we demonstrate that cholesterol catabolism is not required for the activity of these inhibitors. Earlier Cirillo, Jacobs and coworkers, established that the <i>mel2</i> operon residing in the Mce3R regulon is important for persistence and dissemination of <i>Mtb</i> infection in mice (DOI: 10.1128/IAI.01481-08). Thus, an important role of cholesterol utilization for survival of <i>Mtb</i> infection is stress resistance.</div><div>Importantly, we demonstrate that this stress-resistance pathway is vulnerable to small molecule targeting. </div></div>


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259181
Author(s):  
Andrea Olga Papadopoulos ◽  
Christopher Ealand ◽  
Bhavna Gowan Gordhan ◽  
Michael VanNieuwenhze ◽  
Bavesh Davandra Kana

Mycobacterium tuberculosis, the causative agent of tuberculosis remains a global health concern, further compounded by the high rates of HIV-TB co-infection and emergence of multi- and extensive drug resistant TB, all of which have hampered efforts to eradicate this disease. As a result, novel anti-tubercular interventions are urgently required, with the peptidoglycan component of the M. tuberculosis cell wall emerging as an attractive drug target. Peptidoglycan M23 endopeptidases can function as active cell wall hydrolases or degenerate activators of hydrolases in a variety of bacteria, contributing to important processes such as bacterial growth, division and virulence. Herein, we investigate the function of the Rv0950-encoded putative M23 endopeptidase in M. tuberculosis. In silico analysis revealed that this protein is conserved in mycobacteria, with a zinc-binding catalytic site predictive of hydrolytic activity. Transcript analysis indicated that expression of Rv0950c was elevated during lag and log phases of growth and reduced in stationary phase. Deletion of Rv0950c yielded no defects in growth, colony morphology, antibiotic susceptibility or intracellular survival but caused a reduction in cell length. Staining with a monopeptide-derived fluorescent D-amino acid, which spatially reports on sites of active PG biosynthesis or repair, revealed an overall reduction in uptake of the probe in ΔRv0950c. When stained with a dipeptide probe in the presence of cell wall damaging agents, the ΔRv0950c mutant displayed reduced sidewall labelling. As bacterial peptidoglycan metabolism is important for survival and pathogenesis, the role of Rv0950c and other putative M23 endopeptidases in M. tuberculosis should be explored further.


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