Sana Hafeez, Haleema Sajid, Farouk Qamar Malik, Imran Ali Zaidi, Sobia Niaz, Amna Iqtidar

embB Gene association with Ethambutol drug Resistance in Mycobacterium Tuberculosis Patients

Sana Hafeez, Haleema Sajid, Farouk Qamar Malik, Imran Ali Zaidi, Sobia Niaz, Amna Iqtidar



Background: Tuberculosis (TB) is fatal and life threatening infectious disease. The transmission rate of tuberculosis is very high. Various drugs are used as treatment for TB. Recently it has been observed that one of the most important factor for fast TB spread is development of anti-TB drug resistant mycobacterium tuberculosis (MTB). Various combination of drugs like isoniazid (INH), rifampicin (RIF), Streptomycin(SM), pyrazinamide (PZA) or ethambutol (EMB) are in global use for TB treatment. Improper usage of these drugs makes the person prone to develop anti-TB drug resistant tuberculosis.

Aim: To evaluate association of embB gene with ethambutol resistance in Mycobacterium Tuberculosis.

Methods: 104 Specimens of sputum from suspected tuberculosis patients were processed for inoculation in Lowenstein J Medium after it has been decontaminated properly. Kit method by using QIAamp DNA Mini kit was utilized for extraction of DNA. Then region from base 6953 to 10249 of embB gene was amplified through PCR and then followed by sequencing with the aid of softwares blast2seq and ClustalW2. Three primer sets were utilized to amplify embB gene. Ethambutol (EMB) Resistant MTB specimens were processed to study mutation in embB gene.

Results: Out of the total 104 sputum specimens, 14 samples were found to have ethambutol resistance. These 14 samples were then processed for mutational analysis. DNA sequence analysis of these 14 samples confirmed embB gene mutation in 10 samples. Mutational analysis revealed that 08 samples showed mutation at codon 306 and two samples showed mutation at 319 codon. The reported mutation Methionine Isoleucine was seen in 07 samples with ATG codon replaced by ATA codon at codon position 306. One sample showed mutation as Methionine Isoleucine with ATG codon replaced by ATC codon at codon position 306. Two samples showed mutation as Tyrosine Serine with TAT codon replaced by TCT at 319 codon position in embB gene.

Conclusion: This study concludes that mutation of certain genes particularly point mutation of embB gene at codon 306 and 319 is associated with drug resistance of ethambutol in ethambutol resistant mycobacterium tuberculosis patients. 

Keywords: Ethambutol, embB gene, Mycobacterium tuberculosis

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