Investigation of the relationship between the genetic mechanism of pyrazinamide resistance and bedaquiline resistance in Mycobacterium tuberculosis complex strains by molecular methods

Tuberculosis (TB) is one of the oldest known diseases. Today, the increasing number of patients infected with tuberculosis bacilli, especially multidrug-resistant (MDR-MDR) and extensively drug-resistant (XDR-XDR), is the biggest problem in controlling the disease. However, by detecting the molecular mechanism of resistance with advanced molecular methods, appropriate treatment regimens can be determined in a short time. The use of Bedaquiline (BDQ), one of the drugs approved in recent years, together with Pyrazinamide (PZA) suggests that the treatment process is effective. The aim of this study is to evaluate mutations in genes thought to be related to PZA and BDQ resistance among MDR and fully drug-sensitive M. tuberculosis strains isolated from clinical samples of tuberculosis suspects and to question the relationship between them. For a total of 71 MTB samples, 41 MDR and 30 fully sensitive, isolated from clinical material arriving at Adana Regional Tuberculosis Laboratory with a preliminary diagnosis of tuberculosis from 7 different provinces of Turkey, 1 (1.4%) was determined to be M.bovis and 70 (98.6%) were M. tuberculosis, and as a result of the drug sensitivity test (IDT), 30 (73%) of 41 MDR strains were found to be PZA resistant, 11 (27%) were PZA sensitive, and 76% were resistant to isoniazid-rifampicin. While 27 pncA and 14 panD mutations were found by Sanger sequence analysis, no mutations were detected in the hadC and Rv0678 genes.