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Background  The emergence of drug resistance is one of the most important threats to tuberculosis control programs. This study was aimed to analyze the frequency of gene mutations associated with resistance to isoniazid (INH), rifampicin (RMP) and ethambutol (EMB) among  Mycobacterium tuberculosis  isolates from Northwest Ethiopia, and to assess the performance of the GenoType ®  MTBDRplus and GenoType ®  MTBDRsl assays as compared to the BacT/ALERT 3D system.    Methods  Two hundred sixty  Mycobacterium tuberculosis  isolates from smear positive tuberculosis patients diagnosed between March 2009 and July 2009 were included in this study. Drug susceptibility tests were performed in the Institute of Medical Microbiology and Epidemiology of Infectious Diseases, University Hospital of Leipzig, Germany.    Results  Of 260 isolates, mutations conferring resistance to INH, RMP, or EMB were detected in 35, 15, and 8 isolates, respectively, while multidrug resistance (MDR) was present in 13 of the isolates. Of 35 INH resistant strains, 33 had mutations in the  katG  gene at Ser315Thr 1 and two strains had mutation in the  inhA  gene at C15T. Among 15 RMP resistant isolates, 11 had  rpoB  gene mutation at Ser531Leu, one at His526Asp, and three strains had mutations only at the wild type probes. Of 8 EMB resistant strains, two had mutations in the  embB  gene at Met306Ile, one at Met306Val, and five strains had mutations only at the wild type probes. The GenoType ®  MTBDRplus assay had a sensitivity of 92% and specificity of 99% for INH resistance, and 100% sensitivity and specificity to detect RMP resistance and MDR. The GenoType ®  MTBDRsl assay had a sensitivity of 42% and specificity of 100% for EMB resistance.    Conclusion  The dominance of single gene mutations associated with the resistance to INH and RMP was observed in the codon 315 of the  katG  gene and codon 531 of the  rpoB  gene, respectively. The GenoType ®  MTBDRplus assay is a sensitive and specific tool for diagnosis of resistance to INH, RMP and MDR. However, the GenoType ®  MTBDRsl assay shows limitations in detecting resistance to EMB.

Analysis of gene mutations associated with isoniazid, rifampicin and ethambutol resistance among Mycobacterium tuberculosisisolates from Ethiopia