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Novel pncA Mutations in Pyrazinamide-Resistant Isolates of Mycobacterium tuberculosis.

The gene coding for pyrazinamidase (PZase) activity, pncA, in Mycobacterium tuberculosis was recently cloned, and several mutations which correlate with in vitro resistance to pyrazinamide (PZA) have been identified. During the development of a clinical molecular assay for the detection of PZA resistance, two previously unreported mutations in isolates of PZA-resistant M. tuberculosis were identified. The assay that uses automated DNA sequencing is relatively rapid and allows the detection of any mutations present in the coding region of the pncA gene. The new mutations are both point mutations resulting in amino acid substitutions; 241T --> G results in F80V, and 511G --> C results in A171P. The identification of these mutations accentuates the utility of automated DNA sequencing in the clinical laboratory.

Journal Article↗

Early bactericidal action of pulsed exposure to rifampicin, ethambutol, isoniazid & pyrazinamide in pulmonary tuberculosis patients.

The bactericidal action of two therapeutic regimens on Mycobacterium tuberculosis was assessed by viable counts in serial sputum samples in 49 pulmonary tuberculosis patients being treated with rifampicin (R), ethambutol (Emb), isoniazid (I) and pyrazinamide (Z) together in a single dose thrice weekly (REmbIZ3) or with REmb and IZ on alternate days (REmb3IZ3alt). In both groups of patients, there was a significant reduction (P < or = 0.02) in the colony forming units (cfu) of M. tuberculosis per ml of sputum during the first two days of treatment itself. This early bactericidal action (EBA) as well as the reduction in counts during the subsequent days of treatment were similar (P > 0.2) for both REmbIZ3 and REmb3IZ3alt regimens indicating that splitting up REmbIZ into REmb on one day and IZ on the next day in short course chemotherapy (SCC) regimens may not affect the bactericidal action of the regimens.

Antitubercular Agents↗