Drug resistance to streptomycin in the clinical isolates of Mycobacterium tuberculosis (MTB) needs special consideration. It can mostly be caused by mutations in four genes with the names rpsL, rrs, gidB, and whiB7. The main objective of this study was the evaluation of the type and frequency of mutations in these mentioned genes using the PCR-sequencing method. This study was performed on 15 streptomycin-resistant and five streptomycin-sensitive isolates. Among resistant isolates, 11 samples contained mutations in codon 43 of the rpsL gene, which caused the lysine to be converted to arginine. Additionally, all of the isolates had mutations in the gidB. Missense mutations in codons 92 and 20 of this gene result in the amino acids Glutamic acid or Arginine being changed to Aspartic acid or Proline, respectively. No mutations in the rrs or whiB7 were found in any of the samples. Simultaneous mutations of rpsL and gidB were found in 10 isolates, the majority of which were Beijing strain. The results showed that the mutations of rpsL and gidB genes are mostly responsible for the streptomycin resistance in the evaluated MTB isolates. Furthermore, the discovery of dual mutations in Beijing strains highlights the strain's considerable potential for developing Tuberculosis drug resistance.
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