{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:28:07Z","timestamp":1785432487644,"version":"3.56.0"},"reference-count":38,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Tuberculosis is one of the diseases causing high rates of morbidity and mortality in several countries. However, efforts in the use of diagnostic methods for tuberculosis and the detection of drug resistance are essential to reduce cases. Since 2015, rapid molecular diagnostic tests have been implemented in Panama, enabling the detection of drug resistance, mainly rifampicin and isoniazid, in patients with suspected tuberculosis. This study aimed to identify mutations in\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      complex strains with resistance to rifampicin and isoniazid using GenoType MTBDRplus. It is a retrospective study reviewing the results of the GenoType MTBDRplus version 2.0 test from 2015 to 2021. Strains not identified as\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      complex and those that did not show a mutation pattern and were categorized as sensitive were excluded. Data analysis was carried out using the Chi-square tests, Pearson\u2019s Correlation, and principal components analysis. A total of 4,301 strains were analyzed, of which 8.8% were detected with mutation or resistance probes in one or more of the genes analyzed: 56.0% in the\n                      <jats:italic toggle=\"yes\">rpo\u03b2<\/jats:italic>\n                      gene, 11.9% in the\n                      <jats:italic toggle=\"yes\">inhA<\/jats:italic>\n                      gene, and 8.2% in the\n                      <jats:italic toggle=\"yes\">katG<\/jats:italic>\n                      gene. In addition, other mutations such as\n                      <jats:italic toggle=\"yes\">rpo\u03b2\/inhA<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">rpo\u03b2\/katG<\/jats:italic>\n                      were detected in 9.5% and 13.5% of cases, respectively. Thirty-eight resistance patterns were identified, with H526D and S531L being the most frequent mutations in the\n                      <jats:italic toggle=\"yes\">rpoB<\/jats:italic>\n                      gene, and S315T1 and C-15T are the most common in\n                      <jats:italic toggle=\"yes\">katG<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">inhA<\/jats:italic>\n                      , respectively. The resistance patterns detected by the GenoType MTBDRplus assay highlight the genetic variability of drug resistance in the country and emphasize the need to implement epidemiological surveillance methodologies. Integrating patient clinical data with genetic variation information is essential for improving disease control and understanding transmission dynamics and drug resistance acquisition. These findings also provide important insights for guiding tuberculosis treatment strategies in Panama, supporting the use of molecular tools for the early detection of drug resistance, enhancing our understanding of the epidemiology, and informing clinical decision-making.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      This study focuses on understanding how\n                      <jats:italic toggle=\"yes\">Mycobacterium tuberculosis<\/jats:italic>\n                      strains in Panama develop resistance. With tuberculosis (TB) cases becoming harder to treat due to drug resistance, especially after the disruptions caused by the COVID-19 pandemic, rapid and accurate diagnosis is crucial. By using advanced molecular tests to identify specific genetic mutations in drug-resistant TB strains, this research helps improve treatment decisions, leading to better outcomes for patients. Understanding these mutations also aids in controlling the spread of TB. Given the rising global concern over drug-resistant TB, the findings of this study are important not only for Panama but also for other regions facing similar challenges.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02400-24","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T09:00:40Z","timestamp":1749459640000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":1,"title":["Mutations associated with resistance to rifampicin and isoniazid identified in strains of the\n                    <i>Mycobacterium tuberculosis<\/i>\n                    complex by GenoType MTBDRplus in Panama, 2015\u20132021"],"prefix":"10.1128","volume":"13","author":[{"given":"Juan","family":"Dom\u00ednguez Gonz\u00e1lez","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/019ev8b82","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Conmemorativo Gorgas de Estudios de la Salud","place":["Panama City, Panama"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7764-6561","authenticated-orcid":true,"given":"Juan","family":"Castillo Mewa","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/019ev8b82","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Conmemorativo Gorgas de Estudios de la Salud","place":["Panama City, Panama"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prudencio","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/019ev8b82","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Conmemorativo Gorgas de Estudios de la Salud","place":["Panama City, Panama"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Del Cid","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/019ev8b82","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Conmemorativo Gorgas de Estudios de la Salud","place":["Panama City, Panama"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacinto Ariel","family":"P\u00e9rez Ru\u00edz","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/019ev8b82","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Conmemorativo Gorgas de Estudios de la Salud","place":["Panama City, Panama"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9358-7781","authenticated-orcid":true,"given":"Samantha Eunice","family":"Rosas Hermosilla","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/019ev8b82","id-type":"ROR","asserted-by":"publisher"}],"name":"Instituto Conmemorativo Gorgas de Estudios de la Salud","place":["Panama City, Panama"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","volume-title":"Global tuberculosis report 2022","author":"World Health Organization","year":"2022","unstructured":"World Health Organization. 2022. Global tuberculosis report 2022. Geneva."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.17843\/rpmesp.2021.384.7834"},{"key":"e_1_3_2_4_2","unstructured":"Organizaci\u00f3n Panamericana de la Salud. 2020. Comunicaci\u00f3n r\u00e1pida: an\u00e1lisis moleculares como pruebas diagn\u00f3sticas iniciales de la tuberculosis y la resistencia a la rifampicina"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tube.2013.10.001"},{"key":"e_1_3_2_6_2","unstructured":"Organizaci\u00f3n Panamericana de la Salud. 2021. Actualizaci\u00f3n sobre el uso de pruebas de amplificaci\u00f3n de \u00e1cidos nucleicos para detectar la tuberculosis y la tuberculosis farmacorresistente: comunicaci\u00f3n r\u00e1pida"},{"key":"e_1_3_2_7_2","volume-title":"Module 3: diagnosis-rapid diagnostics for tuberculosis diagnosis, 2021 update. WHO operational handbook on tuberculosis","author":"World Health Organization","year":"2021","unstructured":"World Health Organization. 2021. Module 3: diagnosis-rapid diagnostics for tuberculosis diagnosis, 2021 update. WHO operational handbook on tuberculosis. World Health Organization, Geneva."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.15.0389"},{"key":"e_1_3_2_9_2","unstructured":"Hain Lifescience GmbH. 2019. GenoType MTBDRplus VER 2.0 Ensayo de Gen\u00e9tica Molecular para la Identificaci\u00f3n del Complejo M. tuberculosis y su Resistencia a Rifampicina e Isoniacida a partir de Muestras Cl\u00ednicas y de Muestras de Cultivos"},{"key":"e_1_3_2_10_2","unstructured":"Hain Lifescience GmbH. GenoLyse. Available from: https:\/\/www.hain-lifescience.de\/en\/instructions-for-use.html. Retrieved 23 Jun 2022."},{"key":"e_1_3_2_11_2","unstructured":"Applied Biosystems. 2010. GeneAmp PCR system 9700 base module. Foster"},{"key":"e_1_3_2_12_2","unstructured":"Hain Lifescience GmbH. TwinCubator | Manual processing of 12 samples. Available from: https:\/\/www.hain-lifescience.de\/en\/products\/equipment\/hybridization\/twincubator.html. Retrieved 23 Jun 2022."},{"key":"e_1_3_2_13_2","unstructured":"Microbiologics Inc. Mycobacterium tuberculosis derived from ATCC 25177. KWIK-STIK. Available from: https:\/\/www.microbiologics.com\/0112P. 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