Mycobacterium tuberculosis Is Resistant to Isoniazid at a Slow Growth Rate by Single Nucleotide Polymorphisms in katG Codon Ser315

PLoS One. 2015 Sep 18;10(9):e0138253. doi: 10.1371/journal.pone.0138253. eCollection 2015.

Abstract

An important aim for improving TB treatment is to shorten the period of antibiotic therapy without increasing relapse rates or encouraging the development of antibiotic-resistant strains. In any M. tuberculosis population there is a proportion of bacteria that are drug-tolerant; this might be because of pre-existing populations of slow growing/non replicating bacteria that are protected from antibiotic action due to the expression of a phenotype that limits drug activity. We addressed this question by observing populations of either slow growing (constant 69.3h mean generation time) or fast growing bacilli (constant 23.1h mean generation time) in their response to the effects of isoniazid exposure, using controlled and defined growth in chemostats. Phenotypic differences were detected between the populations at the two growth rates including expression of efflux mechanisms and the involvement of antisense RNA/small RNA in the regulation of a drug-tolerant phenotype, which has not been explored previously for M. tuberculosis. Genotypic analyses showed that slow growing bacilli develop resistance to isoniazid through mutations specifically in katG codon Ser315 which are present in approximately 50-90% of all isoniazid-resistant clinical isolates. The fast growing bacilli persisted as a mixed population with katG mutations distributed throughout the gene. Mutations in katG codon Ser315 appear to have a fitness cost in vitro and particularly in fast growing cultures. Our results suggest a requirement for functional katG-encoded catalase-peroxide in the slow growers but not the fast-growing bacteria, which may explain why katG codon Ser315 mutations are favoured in the slow growing cultures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use*
  • Bacterial Proteins / genetics*
  • Catalase / genetics*
  • Codon
  • DNA Mutational Analysis
  • Drug Resistance, Microbial / genetics*
  • Gene Expression Profiling
  • Gene Expression Regulation, Bacterial / drug effects
  • Gene Expression Regulation, Enzymologic / drug effects
  • Humans
  • Isoniazid / pharmacology
  • Isoniazid / therapeutic use*
  • Microbial Sensitivity Tests
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / genetics*
  • Mycobacterium tuberculosis / growth & development*
  • Point Mutation
  • Polymorphism, Single Nucleotide*
  • Serine / genetics
  • Tuberculosis, Multidrug-Resistant / genetics
  • Tuberculosis, Multidrug-Resistant / microbiology

Substances

  • Antitubercular Agents
  • Bacterial Proteins
  • Codon
  • Serine
  • Catalase
  • katG protein, Mycobacterium tuberculosis
  • Isoniazid

Grants and funding

This work was supported by funding from the Innovative Medicines Initiative Joint Undertaking under grant agreement n°115337, resources of which are composed of financial contribution from the European Union’s Seventh Framework Programme (FP7/2007-2013) and EFPIA companies’ in kind contribution. Funding was also received from the Department of Health Grant in Aid and National Institute of Health Research. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research, or the Department of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.