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Some Synonymous and Nonsynonymous $\textit{gyrA}$ Mutations in $\textit{Mycobacterium tuberculosis}$ Lead to Systematic False-Positive Fluoroquinolone Resistance Results with the Hain GenoType MTBDRsl Assays

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Ajileye, A 
Alvarez, N 
Merker, M 
Walker, TM 
Akter, S 


We demonstrated that some non-synonymous and synonymous mutations in gyrA in Mycobacterium tuberculosis result in systematic false-resistance results to fluoroquinolones using the Hain GenoType MTBDRsl assays (version 1 and 2) by preventing the binding of wild-type probes. Moreover, such mutations can prevent the binding of mutant probes, designed for the identification of specific resistance mutations. Although these mutations are likely rare globally, they occur in approximately 7% of multidrug-resistant tuberculosis strains in some settings.



$\textit{Mycobacterium tuberculosis}$, Hain GenoType MTBDRsl, fluoroquinolones

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Antimicrobial Agents and Chemotherapy

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American Society for Microbiology
Wellcome Trust (098600/Z/12/Z)
National Institute for Health and Care Research (HICF-T5-342)
T.M.W. is a University of Oxford National Institute for Health Research (NIHR) academic clinical lecturer. N.A. was supported by a doctoral study fund from Colciencias. T.S. was supported by grants from the Swedish Heart and Lung Foundation and the Marianne and Marcus Wallenberg Foundation. F.C. was supported by the Wellcome Trust (grant 201344/Z/16/Z). D.W.C. and T.E.A.P. are NIHR senior investigators supported by the NIHR Oxford Biomedical Research Centre, NIHR Oxford Health Protection Research Unit on Healthcare Associated Infection and Antimicrobial Resistance (grant HPRU-2012-10041), and the Health Innovation Challenge Fund (grant T5-358). S.N. was supported by grants from the German Center for Infection Research (DZIF), the European Union TB-PAN-NET (grant FP7-223681), and PathoNgenTrace (grant 278864). S.J.P. was supported by the Health Innovation Challenge Fund (grants HICF-T5-342 and WT098600), a parallel funding partnership between the UK Department of Health and Wellcome Trust. C.U.K. is a junior research fellow at Wolfson College, Cambridge.