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This study detected resistance-conferring mutations in<jats:italic>gyrA<\/jats:italic>\/<jats:italic>gyrB<\/jats:italic>for fluoroquinolones and<jats:italic>rrs<\/jats:italic>\/<jats:italic>eis<\/jats:italic>genes for second-line injectable drugs (SLIDs) among multidrug-resistant<jats:italic>Mycobacterium tuberculosis<\/jats:italic>(MDR-TB) isolates in Kuwait. Fifty pansusceptible<jats:italic>M. tuberculosis<\/jats:italic>and 102 MDR-TB strains were tested. Phenotypic susceptibility testing was performed by MGIT 960 system using SIRE drug kit. GenoType MTBDR<jats:italic>sl<\/jats:italic>version 1 (gMTBDR<jats:italic>sl<\/jats:italic>v1) and GenoType MTBDR<jats:italic>sl<\/jats:italic>version 2 (gMTBDR<jats:italic>sl<\/jats:italic>v2) tests were used for mutation detection. Results were validated by PCR-sequencing of respective genes. Fingerprinting was performed by spoligotyping. No mutations were detected in pansusceptible isolates. gMTBDR<jats:italic>sl<\/jats:italic>v1 detected<jats:italic>gyrA<\/jats:italic>mutations in 12 and<jats:italic>rrs<\/jats:italic>mutations in 8 MDR-TB isolates. gMTBDR<jats:italic>sl<\/jats:italic>2 additionally detected<jats:italic>gyrB<\/jats:italic>mutations in 2 and<jats:italic>eis<\/jats:italic>mutation in 1 isolate. Mutations in both<jats:italic>gyrA\/gyrB<\/jats:italic>and<jats:italic>rrs\/eis<\/jats:italic>were not detected. gMTBDR<jats:italic>sl<\/jats:italic>v1 also detected ethambutol resistance-conferring<jats:italic>embB<\/jats:italic>mutations in 59 isolates. Although XDR-TB was not detected, frequency of resistance-conferring mutations for fluoroquinolones or SLIDs was significantly higher among isolates collected during 2013\u20132019 versus 2006\u20132012. Application of both tests is warranted for proper management of MDR-TB patients in Kuwait as gMTBDR<jats:italic>sl<\/jats:italic>v2 detected resistance to fluoroquinolones and\/or SLIDs in 3 additional isolates while gMTBDR<jats:italic>sl<\/jats:italic>v1 additionally detected resistance to ethambutol in 58% of MDR-TB isolates.<\/jats:p>","DOI":"10.1038\/s41598-021-87516-0","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T10:13:19Z","timestamp":1617876799000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Increasing prevalence of resistance to second-line drugs among multidrug-resistant Mycobacterium tuberculosis isolates in Kuwait"],"prefix":"10.1038","volume":"11","author":[{"given":"Noura M.","family":"Al-Mutairi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suhail","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiman","family":"Mokaddas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"key":"87516_CR1","unstructured":"World Health Organization. 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