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Tuberculosis & Respiratory Diseases

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Vol.60 No.2
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Cross-resistance Between Rifampicin and Rifabutin and Its Relationship with rpoB Gene Mutations in Clinically Isolated MDR-TB Strains

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2006, v.60 no.2, pp.171-179




& (2006). Cross-resistance Between Rifampicin and Rifabutin and Its Relationship with rpoB Gene Mutations in Clinically Isolated MDR-TB Strains. Tuberculosis & Respiratory Diseases, 60(2), 171-179.
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Abstract

Background : Despite the emerging danger of MDRTB to human beings, there have only been a limited number of drugs developed to treat MDRTB since 1970. This study investigated the crossresistance rate between rifampicin (RFP) and rifabutin (RBU) in order to determine the efficacy of rifabutin in treating MDRTB. In addition, the results of rifabutin were correlated with the rpoB mutations, which are believed to be markers for MDRTB and RFP resistance.Methods : The MICs of RBU were tested against 126 clinical isolates of MDRTB submitted to the clinical laboratory of National Masan TB Hospital in 2004. Five different concentrations (10160μg/ml) were used for the MICs. The detection of the rpoB mutations was performed using a RFP resistance detection kit with a line probe assay(LiPA), which contains the oligonucleotide probes for 5 wide type and 3 specific mutations (513CCA, 516GTC, and 531TTG) The rpoB mutation was determined by direct sequencing.Results : The rate of crossresistance between RFP and RBU was 70.5%(74/105) at 20μg/ml RBU(ed note: How much RFP?) Most mutations (86.3%) occurred in the 524~534 codons. The His526Gln, His526Leu, Leu533Pro, Gln513Glu, and Leu511Pro mutations(Ed note: Is this correct?) were associated with the susceptibilty to RBU.Conclusion : Based on the crossresistance rate between RFP and RBU, RBU may be used effectively in some MDRTB patients. Therefore, a conventional drug susceptibility test for RBU and a determination of the critical concentration are needed. However, rpoB gene mutation test may be have limited clinical applications in detecting RBU resistance.(Tuberc Respir Dis 2006; 60: 171-179)

keywords
MDR-TB, cross-resistance, rifabutin, rifampin, rpoB mutation, MDR-TB, cross-resistance, rifabutin, rifampin, rpoB mutation

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