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

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.

Construction of a severely attenuated mutant of Mycobacterium tuberculosis for reducing risk to laboratory workers.

The ability to construct defined deletions of Mycobacterium tuberculosis has allowed many genes involved in virulence to be identified. Deletion of nutritional genes leads to varying levels of attenuation, presumably reflecting the need for a particular molecule, and the availability (or lack) of that molecule in vivo. We have previously shown that M. tuberculosis mutants lacking either the trpD or ino1 gene are highly attenuated in mouse models of infection, but can grow when supplemented with tryptophan or inositol, respectively. In this paper we have constructed a double Delta trpDDelta ino1 mutant, and show that this is severely attenuated in SCID mouse and guinea pig models. As the strain will grow in the presence of supplements, we propose that this strain could be used for research and antigen preparative purposes, with reduced risks to laboratory workers.

Transcriptional responses of Mycobacterium tuberculosis exposed to adverse conditions in vitro.

Mycobacterium tuberculosis encounters a range of stimuli in the host. Understanding the environmental cues that initiate the transcriptional response of M. tuberculosis, which enable the bacterium to replicate and/or survive in the host, will provide markers that are specific to different stages of disease, further refining the search for improved treatments and vaccines. Studying M. tuberculosis gene expression in vivo is technically challenging and more amenable in vitro experiments are being used to aid interpretation and to dissect the signals that are responsible for controlling subsets of genes. Key parameters that affect the growth of a pathogen in the host include nutrient status, environmental pH, oxygen availability, and host defences. Studying gene expression, pathogenicity, and physiology of M. tuberculosis that has been exposed to these relevant host conditions in vitro will further increase our understanding of the virulence factors that M. tuberculosis requires to establish disease. Complementary information obtained by metabolic flux analysis, proteomics, and regulatory networks analysis will enable a clearer picture of how transcriptional responses translate to changes in the metabolome and physiology of the organism.