First report of molecular detection of fluoroquinolone resistance-associated gyrA mutations in multidrug-resistant clinical Mycobacterium tuberculosis isolates in Kuwait

Table 2 Patient's demographic data and fingerprinting data for the four individual patient multidrug-resistant M. tuberculosi s strains containing a mutation in quinolone resistance-determining region (QRDR) of gyrA gene.

Patient	Nationality	Clinical	Year of	Resistance	Mutation in QRDR	Fingerprinting data from analysis of^b
no.		specimen	isolation	pattern^a	of gyrA gene	rpoB ^c	inhA -RR ^d	Genetic group^e
1	Indian	Pleural fluid	2004	H, R, S, E	GAC94GGC/D94G	Wild-type^f	WT	I
2	Bangladeshi	Sputum	2006	H, R, S, E	GAC94GCC/D94A	H526Q + D516G	WT	III
3*	Indian	Sputum	2006	H, R, E	GAC94GGC/D94G	I572F	WT	I
4	Indian	Sputum	2008	H, R, E	GAC94GGC/D94G	S531L	-17G→T	I

^aH, isoniazid; R, rifampicin, S, streptomycin; E, ethambutol
^bAll four were male patients and all individual patient isolates contained AGC315ACC mutation in katG codon 315 and yielded unique patterns in DRE-PCR
^cThree (hot-spot, N-terminal and cluster II) regions of rpoB gene were sequenced to detect rifampicin resistance-conferring mutations and codon numbering system of rpoB gene from Escherichia coli is used [4]
^dInhA-RR, inhA regulatory region sequencing data
^eGenetic groups were assigned based on polymorphisms at katG codon 463 and gyrA codon 95(L463/T95, Group I; R463/S95, Group III)
^fThis isolate either contained a mutation in other regions of the rpoB gene or in other genes involved in rifampicin resistance [25]
*Two repeat isolates recovered from this patient exhibited identical patterns

ISSN: 1756-0500