Correlation Between Xpert MTB/RIF Results and rpoB Mutations within Probe-Targeted Regions in Mycobacterium tuberculosis Isolates from Sichuan Basin.

IF 2.9 3区医学 Q2 INFECTIOUS DISEASES

Infection and Drug Resistance Pub Date : 2025-09-29 eCollection Date: 2025-01-01 DOI:10.2147/IDR.S541544

Kun Li, Long Li

{"title":"Correlation Between Xpert MTB/RIF Results and rpoB Mutations within Probe-Targeted Regions in Mycobacterium tuberculosis Isolates from Sichuan Basin.","authors":"Kun Li, Long Li","doi":"10.2147/IDR.S541544","DOIUrl":null,"url":null,"abstract":"Purpose: This study characterized mutation patterns within the rifampicin resistance-determining region (RRDR) of the rpoBgene (codons 507-533), targeted by Xpert MTB/RIF probes, in Mycobacterium tuberculosis isolates from Southwest China. Regional molecular profiles were and compared regional profiles against global datasets to elucidate implications for rifampicin resistance surveillance.Methods: We conducted a retrospective study of 197 rifampicin-resistant tuberculosis cases involving 197 cases of rifampicin-resistant tuberculosis (comprising 194 pulmonary and 3 extrapulmonary cases) confirmed through the GeneXpert MTB/RIF assay at Suining Central Hospital during 2023-2024. Mutation characteristics across five RRDR probes (labeled A-E) were assessed, along with the semi-quantitative classification of bacterial loads.Results: Single-probe mutations predominated (82.7%; 163/197), with hotspots at Probe E (S531L, 55.8%) and Probe A (Q510H/V511D, 12.2%). Dual-probe mutations (16.8%, 33/197) were primarily A+B combinations (13.7%, 27/197), showing significantly elevated prevalence in patients aged 46-60 years (OR = 2.31, 95% CI: 1.12-4.79, P< 0.05). Bacterial load stratification revealed strong diagnostic accuracy associations: smear positivity rates were 79.4% (high load) and 44.4% (medium), while culture positivity rates were 67.6% and 57.8%, respectively.Conclusion: A unique double-peak mutation pattern (primarily involving probes E and A) was identified in Sichuan Province, which contrasts sharply with the single hotspot pattern observed in Europe and the epidemiological pattern in Beijing, China, where probe E predominates. The elevated Probe A mutation rate (12.2%) potentially reflects regional rifabutin usage in second-line regimens. These findings provide molecular epidemiological insights for optimizing diagnosis and drug resistance monitoring in southwestern China.","PeriodicalId":13577,"journal":{"name":"Infection and Drug Resistance","volume":"18 ","pages":"5161-5171"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12493105/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Infection and Drug Resistance","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IDR.S541544","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: This study characterized mutation patterns within the rifampicin resistance-determining region (RRDR) of the rpoBgene (codons 507-533), targeted by Xpert MTB/RIF probes, in Mycobacterium tuberculosis isolates from Southwest China. Regional molecular profiles were and compared regional profiles against global datasets to elucidate implications for rifampicin resistance surveillance.

Methods: We conducted a retrospective study of 197 rifampicin-resistant tuberculosis cases involving 197 cases of rifampicin-resistant tuberculosis (comprising 194 pulmonary and 3 extrapulmonary cases) confirmed through the GeneXpert MTB/RIF assay at Suining Central Hospital during 2023-2024. Mutation characteristics across five RRDR probes (labeled A-E) were assessed, along with the semi-quantitative classification of bacterial loads.

Results: Single-probe mutations predominated (82.7%; 163/197), with hotspots at Probe E (S531L, 55.8%) and Probe A (Q510H/V511D, 12.2%). Dual-probe mutations (16.8%, 33/197) were primarily A+B combinations (13.7%, 27/197), showing significantly elevated prevalence in patients aged 46-60 years (OR = 2.31, 95% CI: 1.12-4.79, P< 0.05). Bacterial load stratification revealed strong diagnostic accuracy associations: smear positivity rates were 79.4% (high load) and 44.4% (medium), while culture positivity rates were 67.6% and 57.8%, respectively.

Conclusion: A unique double-peak mutation pattern (primarily involving probes E and A) was identified in Sichuan Province, which contrasts sharply with the single hotspot pattern observed in Europe and the epidemiological pattern in Beijing, China, where probe E predominates. The elevated Probe A mutation rate (12.2%) potentially reflects regional rifabutin usage in second-line regimens. These findings provide molecular epidemiological insights for optimizing diagnosis and drug resistance monitoring in southwestern China.

Abstract Image

查看原文本刊更多论文

四川盆地结核分枝杆菌Xpert MTB/RIF检测结果与探针靶区rpoB突变的相关性

目的：研究Xpert MTB/RIF探针对中国西南地区结核分枝杆菌rpob基因（密码子507-533）利福平耐药决定区（RRDR）的突变模式。将区域分子谱与全球数据集进行比较，以阐明利福平耐药性监测的意义。方法：对2023-2024年睢宁市中心医院通过GeneXpert MTB/RIF检测确诊的197例利福平耐药结核病患者进行回顾性研究，其中197例为利福平耐药结核病（194例为肺部病例，3例为肺外病例）。评估了五种RRDR探针（标记为A-E）的突变特征，以及细菌负荷的半定量分类。结果：单探针突变占主导地位（82.7%;163/197），热点在探针E （S531L, 55.8%）和探针A （Q510H/V511D, 12.2%）。双探针突变（16.8%,33/197）主要为A+B组合（13.7%,27/197），46 ~ 60岁患者患病率显著升高（OR = 2.31, 95% CI: 1.12 ~ 4.79， P< 0.05）。细菌负荷分层显示出很强的诊断准确性相关性：涂片阳性率为79.4%（高负荷）和44.4%（中负荷），培养阳性率分别为67.6%和57.8%。结论：在四川省发现了一种独特的双峰突变模式（主要涉及探针E和A），这与欧洲观察到的单热点模式和中国北京的流行病学模式形成鲜明对比，其中探针E占主导地位。Probe A突变率升高（12.2%）可能反映了瑞法布汀在二线方案中的区域使用。这些发现为优化西南地区耐药诊断和耐药监测提供了分子流行病学见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Infection and Drug Resistance Medicine-Pharmacology (medical)

CiteScore

5.60

自引率

7.70%

发文量

826

审稿时长

16 weeks

期刊介绍： About Journal Editors Peer Reviewers Articles Article Publishing Charges Aims and Scope Call For Papers ISSN: 1178-6973 Editor-in-Chief: Professor Suresh Antony An international, peer-reviewed, open access journal that focuses on the optimal treatment of infection (bacterial, fungal and viral) and the development and institution of preventative strategies to minimize the development and spread of resistance.