ArticlePloS one2025
Patterns of compensatory mutations in rpoA/B/C genes of multidrug resistant M. tuberculosis in Uganda.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Mutations in rpoB, a gene that encodes the bacterial RNA polymerase (RNAP) beta-subunit, can cause high-level resistance to rifampicin. Approximately 95% of rifampicin-resistant Mycobacterium tuberculosis clinical isolates harbour mutations in an 81-base pair rpoB region referred to as the rifampicin-resistance-determining region (rpoB/RRDR). Also, rifampicin-resistant M. tuberculosis clinical isolates carry multiple mutations in RNAP genes (i.e., rpoA, rpoB, rpoC, rpoD), particularly rpoA and rpoC, which encode the alpha- (α2) and beta'- (β') subunits, respectively. Such secondary mutations offset the fitness cost associated with acquisition of rifampicin-resistance mutations in M. tuberculosis, resulting in resistant strains that are as fit as the wild-type drug-susceptible strains. To analyse the patterns of compensatory mutations in RNAP encoding genes of rifampicin-resistant M. tuberculosis clinical isolates in Uganda, whole genome sequencing and Sanger DNA sequencing were performed on 52 M. tuberculosis clinical isolates - 20 drug-susceptible and 32 multidrug resistant (MDR). A total of 24 (75%) MDR-TB isolates had high-level rifampicin-resistance-conferring mutations in rpoB/RRDR, i.e., Ser531Leu (31%); His526Asp (6%); His526Leu (3%); His526Tyr (3%); His526Arg (3%); His526Gly (3%); Asp516Tyr (13%); Asp516Val (6%); Glu513Lys (3%); Leu511Pro (3%); Leu492Leu (3%); Gln490Arg (3%). Further, two putative compensatory mutations (Gln490Arg & Lys1025Glu) outside the RRDR and not resistance-conferring were found in rpoB. Altogether, 15 (63%, 15/24) MDR-TB isolates with rpoB/RRDR resistance-conferring mutations had non-synonymous mutations in rpoC of the following patterns Leu39Phe (3%); Tyr61His (3%); Asp271Gly (3%); Ser377Ala (3%); Pro481Thr (3%); Val483Ala (6%); Leu516Pro (3%); Ala521Asp (3%); Gly594Glu (13%); Asn698Ser (3%); Leu823Pro (3%). In conclusion, putative compensatory mutations are prevalent in rifampicin-resistant M. tuberculosis clinical isolates in Uganda, with rpoC/Gly594Glu and rpoC/Val483Ala as the most frequent. Further studies will determine their association with strain genetic background, fitness and transmission in an endemic setting with a high burden of HIV-TB coinfection.
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