M. Mestdagh et al., Correlation of pncA sequence with pyrazinamide resistance level in BACTEC (TM) for 21 Mycobacterium tuberculosis clinical isolates, MICROB DR R, 6(4), 2000, pp. 283-287
Mutations in the pncA gene, encoding pyrazinamidase, are considered the maj
or mechanism of pyrazinamide (PZA) resistance in Mycobacterium tuberculosis
, but resistant strains containing the wild-type gene have been described.
The correlation of pncA sequence with PZA resistance level was examined for
21 M, tuberculosis clinical isolates, Susceptibility patterns were determi
ned for 100, 300, and 900 mug/ml concentrations of the drug in BACTEC(TM),
Insertions and deletions and a substitution in the putative promoter region
led to high-level resistance, whereas substitutions within the open readin
g frame seemed to confer variable levels of resistance. Variable resistance
levels and PZase activities were also observed among isolates lacking pncA
mutations. The high-level resistance (900 mug/ml) in pncA wild-type isolat
es highlights the clinical significance of these isolates. These data also
suggest that there may still be more than one alternative mechanism leading
to PZA resistance in M. tuberculosis isolates.