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Genetic Variation Putatively Associated with Mycobacterium tuberculosis Resistance to Perchlozone, a New Thiosemicarbazone: Clues from Whole Genome Sequencing and Implications for Treatment of Multidrug-Resistant Tuberculosis

1
Laboratory of Molecular Epidemiology and Evolutionary Genetics, St. Petersburg Pasteur Institute, 197101 St. Petersburg, Russia
2
Kaliningrad Regional Anti-Tuberculosis Dispensary, 236010 Kaliningrad, Russia
3
St. Petersburg Research Institute of Phthisiopulmonology, 197101 St. Petersburg, Russia
*
Author to whom correspondence should be addressed.
Antibiotics 2020, 9(10), 669; https://doi.org/10.3390/antibiotics9100669
Received: 7 September 2020 / Revised: 27 September 2020 / Accepted: 2 October 2020 / Published: 3 October 2020
Perchlozone ([PCZ] 4-thioureido-iminomethylpyridinium perchlorate) is a new thiosemicarbazone approved for the treatment of multidrug-resistant tuberculosis (MDR-TB) in Russia and some other countries. The ethA and hadABC mutations may confer PCZ resistance. At the same time, ethA mutations are known to mediate resistance to ethionamide (ETH) and prothionamide (PTH). We aimed to study the genetic variation underlying Mycobacterium tuberculosis resistance to PCZ through whole genome sequencing (WGS) of consecutive isolates recovered during long-term treatment. This prospective study included patients admitted in 2018–2019 to the regional tuberculosis dispensary, Kaliningrad, Russia, whose treatment regimen included PCZ. Multiple M. tuberculosis isolates were recovered during PCZ treatment, and the bacterial DNA was subjected to WGS followed by bioinformatics analysis. We identified mutations in the genes putatively associated with PCZ resistance, ethA, and hadA. The most frequent one was a frameshift ethA 106 GA > G (seven of nine patients) and most of the other mutations were also likely present before PCZ treatment. In one patient, a frameshift mutation ethA 702 CT > C emerged after six months of PCZ treatment. A frequent presence of cross-resistance mutations to PCZ and ETH/PTH should be taken into consideration when PCZ is included in the treatment regimen of MDR-TB patients. View Full-Text
Keywords: Mycobacterium tuberculosis; drug resistance; perchlozone; thiosemicarbazone; ethionamide; ethA; hadABC Mycobacterium tuberculosis; drug resistance; perchlozone; thiosemicarbazone; ethionamide; ethA; hadABC
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MDPI and ACS Style

Mokrousov, I.; Vyazovaya, A.; Akhmedova, G.; Solovieva, N.; Turkin, E.; Zhuravlev, V. Genetic Variation Putatively Associated with Mycobacterium tuberculosis Resistance to Perchlozone, a New Thiosemicarbazone: Clues from Whole Genome Sequencing and Implications for Treatment of Multidrug-Resistant Tuberculosis. Antibiotics 2020, 9, 669. https://doi.org/10.3390/antibiotics9100669

AMA Style

Mokrousov I, Vyazovaya A, Akhmedova G, Solovieva N, Turkin E, Zhuravlev V. Genetic Variation Putatively Associated with Mycobacterium tuberculosis Resistance to Perchlozone, a New Thiosemicarbazone: Clues from Whole Genome Sequencing and Implications for Treatment of Multidrug-Resistant Tuberculosis. Antibiotics. 2020; 9(10):669. https://doi.org/10.3390/antibiotics9100669

Chicago/Turabian Style

Mokrousov, Igor, Anna Vyazovaya, Gulnora Akhmedova, Natalia Solovieva, Eugeni Turkin, and Viacheslav Zhuravlev. 2020. "Genetic Variation Putatively Associated with Mycobacterium tuberculosis Resistance to Perchlozone, a New Thiosemicarbazone: Clues from Whole Genome Sequencing and Implications for Treatment of Multidrug-Resistant Tuberculosis" Antibiotics 9, no. 10: 669. https://doi.org/10.3390/antibiotics9100669

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