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Background  Tuberculosis (TB) is one of the major public health problems in Congo. However, data concerning  Mycobacterium tuberculosis  drug resistance are lacking because of the insufficient processing capacity. So, the aim of this study was to investigate for the first time the resistance patterns and the strain lineages of a sample of  M. tuberculosis  complex (MTBC) isolates collected in the two main cities of Congo.    Methods  Over a 9-day period, 114 smear-positive sputa isolated from 114 patients attending centers for the diagnosis and treatment of TB in Brazzaville and Pointe Noire were collected for culture and drug susceptibility testing (DST). Detection of mutations conferring drug resistance was performed by using line probe assays (GenoType MTBDR plus  and MTBDR sl ) and DNA sequencing. Strain lineages were determined by MIRU-VNTR genotyping.    Results  Of the 114 sputa, 46 were culture positive for MTBC. Twenty-one (46%) were resistant to one or more first-line antiTB drugs. Of these, 15 (71%) were multidrug resistant (MDR). The most prevalent mutations involved in rifampin and isoniazid resistance, D516V (60%) in  rpoB  and S315T (87%) in  katG  respectively, were well detected by MTBDR plus  assay. All the 15 MDR strains were susceptible to fluoroquinolone and injectable second-line drug. No mutation was detected in the  rrs  locus involved in resistance to amikacin and capreomycin by both the MTBDR sl  assay and DNA sequencing. By contrast, 9 MDR strains belonging to the same cluster related to T-family were identified as being falsely resistant to fluoroquinolone by the MTBDR sl  assay due to the presence of a double substitution T80A-A90G in GyrA.    Conclusions  Taken together, these data revealed a possible spread of a particular MDR clone in Congo, misidentified as fluoroquinolone resistant by MTBDR sl  assay. Thus, this test cannot replace gold-standard culture method and should be interpreted carefully in view of the patient's native land.

plos one

First Evaluation of Drug-Resistant Mycobacterium tuberculosis Clinical Isolates from Congo Revealed Misdetection of Fluoroquinolone Resistance by Line Probe Assay Due to a Double Substitution T80A-A90G in GyrA