{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T09:17:37Z","timestamp":1776763057088,"version":"3.51.2"},"reference-count":81,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T00:00:00Z","timestamp":1710806400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study examined the patterns and frequency of genetic changes responsible for resistance to first-line (rifampicin and isoniazid), fluoroquinolones, and second-line injectable drugs in drug-resistant <jats:italic>Mycobacterium tuberculosis<\/jats:italic> (MTB) isolated from culture-positive pulmonary tuberculosis (PTB) symptomatic attendees of spiritual holy water sites (HWSs) in the Amhara region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>From June 2019 to March 2020, a cross-sectional study was carried out. A total of 122 culture-positive MTB isolates from PTB-suspected attendees of HWSs in the Amhara region were evaluated for their drug resistance profiles, and characterized gene mutations conferring resistance to rifampicin (RIF), isoniazid (INH), fluoroquinolones (FLQs), and second-line injectable drugs (SLIDs) using GenoType\u00aeMTBDR<jats:italic>plus<\/jats:italic> VER2.0 and GenoType\u00aeMTBDR<jats:italic>sl<\/jats:italic> VER2.0. Drug-resistant MTB isolates were Spoligotyped following the manufacturer\u2019s protocol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Genetic changes (mutations) responsible for resistance to RIF, INH, and FLQs were identified in 15\/122 (12.3%), 20\/122 (16.4%), and 5\/20 (25%) of MTB isolates, respectively. In RIF-resistant, <jats:italic>rpo<\/jats:italic>B\/Ser<jats:bold>531<\/jats:bold>Lue (<jats:italic>n<\/jats:italic>\u2009=\u200912, 80%) was most frequent followed by His<jats:bold>526<\/jats:bold>Tyr (6.7%). Amongst INH-resistant isolates, <jats:italic>kat<\/jats:italic>G\/Ser<jats:bold>315<\/jats:bold>Thr1 (<jats:italic>n<\/jats:italic>\u2009=\u200919, 95%) was the most frequent. Of 15 MDR-TB, the majority (<jats:italic>n<\/jats:italic>\u2009=\u200912, 80%) isolates had mutations at both <jats:italic>rpo<\/jats:italic>B\/Ser<jats:bold>531<\/jats:bold>Leu and <jats:italic>kat<\/jats:italic>G\/Ser<jats:bold>315<\/jats:bold>Thr1. All 20 INH and\/or RIF-resistant isolates were tested with the MTBDR<jats:italic>sl<\/jats:italic> VER 2.0, yielding 5 FLQs-resistant isolates with gene mutations at <jats:italic>rpo<\/jats:italic>B\/Ser<jats:bold>531<\/jats:bold>Lue, <jats:italic>kat<\/jats:italic>G\/Ser<jats:bold>315<\/jats:bold>Thr1, and <jats:italic>gyr<\/jats:italic>A\/Asp<jats:bold>94<\/jats:bold>Ala genes. Of 20 Spoligotyped drug-resistant MTB isolates, the majority (<jats:italic>n<\/jats:italic>\u2009=\u200911, 55%) and 6 (30%) were SIT149\/T3-ETH and SIT21\/CAS1-Kili sublineages, respectively; and they were any INH-resistant (mono-hetero\/multi-). Of 15 RIF-resistant (RR\/MDR-TB) isolates, 7 were SIT149\/T3-ETH, while 6 were SIT21\/CAS1-Kili sublineages. FLQ resistance was detected in four SIT21\/CAS1-Kili lineages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In the current study, the most common gene mutations responsible for resistance to INH, RIF, and FLQs were identified. SIT149\/T3-ETH and SIT21\/CAS1-Kili constitute the majority of drug-resistant TB (DR-TB) isolates. To further understand the complete spectrum of genetic changes\/mutations and related genotypes, a sequencing technology is warranted.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1356826","type":"journal-article","created":{"date-parts":[[2024,3,19]],"date-time":"2024-03-19T04:46:32Z","timestamp":1710823592000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Patterns and profiles of drug resistance-conferring mutations in Mycobacterium tuberculosis genotypes isolated from tuberculosis-suspected attendees of spiritual holy water sites in Northwest Ethiopia"],"prefix":"10.3389","volume":"12","author":[{"given":"Melese Abate","family":"Reta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nontuthuko Excellent","family":"Maningi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P. 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