ArticleBMC infectious diseases2025
Surveillance and analysis of drug resistance and drug resistance levels in multidrug resistant tuberculosis on the tropical islands of China.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Open-access genomic drug resistance prediction tools forJournal of clinical microbiology · 2026Pooled it
- ZILA-SRM: a probabilistic framework with zero-inflated latent models for robust strain reconstruction from metagenomes.Microbiology spectrum · 2026Article
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8 authors.
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Abstract
objectiveMultidrug-resistant tuberculosis (MDR-TB) remains a major public health challenge in China. Hainan, China's largest tropical island, possesses distinct socio-geographical features. However, the drug resistance patterns and molecular epidemiology of MDR-TB in this region have not been fully elucidated. This study aimed to assess the correlation between drug resistance genotypes and phenotypic resistance levels in multidrug-resistant Mycobacterium tuberculosis (MDR-MTB) strains collected from Hainan Island, using whole-genome sequencing (WGS) and phenotypic drug susceptibility testing (DST).
methodsMDR-MTB strains isolated from patients on Hainan Island (2019-2021) were analyzed. Minimum inhibitory concentrations (MIC) for 15 anti-TB drugs were determined by broth microdilution (BMD). Whole-genome sequencing (WGS) was performed using Illumina NovaSeq 6000. Genotypic resistance was predicted via TB-Profiler, and correlations between resistance mutations and MIC levels were assessed.
resultsA total of 209 MDR-MTB strains were analyzed. Strains of lineage 2.2 exhibited significantly higher resistance to ethambutol (EMB) compared to non-lineage 2 strains (P < 0.05). The sensitivity of WGS in predicting resistance to first-line drugs isoniazid (INH), rifampicin (RIF), EMB, and pyrazinamide (PZA) was 94.7%, 99.0%, 96.5%, and 80.8%, respectively. However, specificity for EMB and PZA was lower at 60.2% and 79.4%. WGS also demonstrated high sensitivity and specificity (> 95%) for second-line injectable aminoglycosides (amikacin [AMK], capreomycin [CPM], and kanamycin [KM]), but sensitivity for other second-line drugs except for fluoroquinolone drug moxifloxacin (MOX, 94.4%) was below 80.0%. Notably, mutations in katG_S315T, rpoB_S450L, and gyrA_D94G were strongly associated with high-level resistance, while mutations in fabG1, ahpC, embA promoters, and gyrA at codon 90 were linked to low-level resistance.
conclusionsThis study quantitatively demonstrates the relationship between specific drug resistance genotypes and resistance levels. It is the first to characterize the regional resistance spectrum of MDR-MTB strains on Hainan Island. These findings offer a novel foundation for MIC-based dose adjustment and the optimization of treatment strategies in this region.
trial registrationMR-46-23-020530. Date of registration:2023-07-03.
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