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Mutations responsible for Mycobacterium tuberculosis isoniazid resistance in Italy

Authors: Rindi, L.1; Bianchi, L.1; Tortoli, E.2; Lari, N.1; Bonanni, D.1; Garzelli, C.1

Source: The International Journal of Tuberculosis and Lung Disease, Volume 9, Number 1, January 2005 , pp. 94-97(4)

Publisher: International Union Against Tuberculosis and Lung Disease

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SETTING: The incidence of tuberculosis (TB) and drug resistance in Italy is low compared to other countries. Mutations in several genomic regions of Mycobacterium tuberculosis are involved in the occurrence of isoniazid (INH) resistance.

OBJECTIVE: To investigate the mutations responsible for INH resistance among Italian isolates of M. tuberculosis, to assess the feasibility of predicting drug resistance using a genetic approach.

DESIGN: The mutations responsible for INH resistance were looked for in selected regions of genes katG, kasA and ndh and in the promoter regions of inhA and ahpC by nucleotide sequencing, and the results were compared with data reported in other studies.

RESULTS: Prevalent INH resistance mutations were found at codon 315 of the katG gene and at position −15 of the inhA regulatory region (respectively 37.8% and 20.0% of isolates). The prevalence of mutations at position −24 of inhA, in ahpC, and in kasA ranged from 2.2% to 4.4%. No mutations were found in 35.6% of the isolates.

CONCLUSION: The identification of INH resistance by genetic analysis of the selected regions may be inappropriate in areas with a low prevalence of TB, such as Italy, as the genetic mechanisms of resistance remain unidentified for approximately one third of the isolates.

Keywords: drug resistance; isoniazid; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Dipartmento di Patologia Sperimentale, Biotecnologie Mediche, Infettivologia ed Epidemiologia, Università di Pisa, Pisa, Italy 2: Centro Regionale di Riferimento per i Micobatteri, Laboratorio di Microbiologia e Virologia, Ospedale Careggi, Florence, Italy

Publication date: January 1, 2005

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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