Detection of Mutations and Genotyping of Drug-Resistant <em>Mycobacterium tuberculosis</em> Strains Isolated from Patients in Rural Eastern Cape Province

In South Africa, drug-resistant tuberculosis (DR-TB) continues to be a serious public health issue. Gene mutations and the genotyping of DR-TB in a rural Eastern Cape Province have not previously been studied. We detected prevalent mutations of DR-TB, identified genetic diversity, and assigned lineages. Sputum specimens obtained from 1157 patients suspected with tuberculosis were assayed for rifam-pin-resistance using Xpert® MTB/RIF.and detection of mutations conferring resistance to anti-TB drugs was carried out using GenoType MTBDRplus VER 2.0. Thereafter, 441 isolates were spoligotyped. The most prevalent rifampin resistance-conferring mutations were in rpoB codon S531L. The INH resistant strains, 54.5% had mutations in katG gene at codon S315TB and 24.7% with mutations in inhA gene at codon C-15TB. Furthermore 69.9% strains displayed mutations involving both rpoB and katG genes, while 24.6% strains displayed mutations involving both rpoB and inhA genes. Overall prevalence of hetero-resistance was 17.9%. Beijing family was predominant from Spoligotyping analysis. The diversity of mutations in the study provides information for investigating the evolutional lineages of M. tuberculosis isolates. The recognition frequency of rpoB, katG and inhA mutations in different study areas may help to guide decision‑making about standardization of treatment regimens or individualized treatment in areas where these mutations have been found.