{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:19:49Z","timestamp":1783430389085,"version":"3.54.6"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"\n Background:<\/jats:title>\n \n Drug-resistant tuberculosis (TB), especially rifampicin-resistant and multidrug-resistant TB, remains a significant public health challenge worldwide. Rapid and accurate methods for molecular diagnostics, such as first-line line probe assay (FL-LPA), are recommended by the World Health Organization for early detection of Rif and isoniazid resistance. However, limited data are available comparing resistance patterns between extrapulmonary TB (EPTB) and pulmonary TB (PTB). This study aims to compare first-line anti-tubercular drug resistance patterns and molecular mutations associated with\n katG, rpoB,<\/jats:italic>\n and\n inhA<\/jats:italic>\n genes between PTB and EPTB.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This study was a prospective analysis of 471\n Mycobacterium tuberculosis<\/jats:italic>\n samples subjected to the FL-LPA or the genotype MTBDRplus for the detection of Rif, isoniazid, and multidrug resistance. Demographic, clinical, microbiological, and molecular resistance data were compared between PTB and EPTB isolates. Resistance-associated mutations in the\n rpoB<\/jats:italic>\n ,\n katG<\/jats:italic>\n , and\n inhA<\/jats:italic>\n genes were evaluated.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n PTB accounted for the majority of samples (94.1%), whereas EPTB constituted 5.9%. PTB patients were more likely to be male, while EPTB patients were more likely to be female. The majority of drug resistance, or 94.1% of all resistant patterns, was found in PTB samples. The most prevalent resistance profile, especially in PTB patients, was isoniazid mono-resistance (H), which was mostly linked to the\n katG<\/jats:italic>\n S315T mutation and indicated high-level isoniazid resistance. Canonical rpoB mutations in the rifampicin (Rif) resistance-determining region, such as S531 L, D516V, and H526 replacements, were the main cause of Rif resistance. In line with their paucibacillary character, EPTB cases showed decreased bacillary burden, lower smear positivity, and a narrow range of resistance-associated mutations. Both PTB and EPTB isolates had InhA promoter alterations linked to low-level isoniazid resistance.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n The study demonstrates a substantially higher burden of molecular drug resistance in PTB than in EPTB. The predominance of canonical\n rpoB<\/jats:italic>\n and\n katG<\/jats:italic>\n mutations highlights ongoing transmission of drug-resistant strains, emphasizing the value of FL-LPA in the routine TB diagnosis. Globally, molecular drug susceptibility testing, including extrapulmonary specimens, remains essential to guide appropriate therapy and strengthen TB control efforts under national and global elimination programs.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijmy.ijmy_85_26","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:18:16Z","timestamp":1782857896000},"page":"104-114","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Genotypic Characterization of Drug Resistance-associated Mutations in Mycobacterium tuberculosis Using Line Probe Assays in Central India"],"prefix":"10.4103","volume":"15","author":[{"given":"Antisha","family":"Tiwari","sequence":"first","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaina","family":"Gaikwad","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Dangi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falguni","family":"Agrawal","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maneesh","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitendra","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagar","family":"Khadanga","sequence":"additional","affiliation":[{"name":"Department of General Medicine and All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkesh","family":"Khurana","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashank","family":"Purwar","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debasis","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand Kumar","family":"Maurya","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"R1-20260707","doi-asserted-by":"crossref","first-page":"429","DOI":"10.4103\/ijmy.ijmy_176_22","article-title":"Line probe assay test in new cases of tuberculosis with rifampicin resistance not detected by Xpert MTB\/RIF","volume":"11","author":"Soedarsono","year":"2022","journal-title":"Int J Mycobacteriol"},{"key":"R3-20260707","doi-asserted-by":"crossref","first-page":"91","DOI":"10.4103\/ijmy.ijmy_21_24","article-title":"Rapid detection of M. tuberculosis and Its resistance to rifampicin and isoniazid with the mfloDx\u2122 MDR-TB test","volume":"13","author":"Ramasubban","year":"2024","journal-title":"Int J Mycobacteriol"},{"key":"R5-20260707","doi-asserted-by":"crossref","first-page":"60","DOI":"10.4103\/0974-777X.157237","article-title":"Utility of line probe assay for the early detection of multidrug-resistant pulmonary tuberculosis","volume":"7","author":"Madhuri","year":"2015","journal-title":"J Glob Infect Dis"},{"issue":"Suppl 1","key":"R6-20260707","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.1016\/j.ijtb.2024.01.009","article-title":"Mutational analysis in drug resistant Mycobacterium tuberculosis in Western Uttar Pradesh","volume":"71","author":"Mishra","year":"2024","journal-title":"Indian J Tuberc"},{"key":"R7-20260707","first-page":"50","article-title":"A standardised method for interpreting the association between mutations and phenotypic drug resistance in Mycobacterium tuberculosis","author":"Miotto","year":"2017","journal-title":"European Respiratory Journal"},{"key":"R9-20260707","doi-asserted-by":"crossref","first-page":"435","DOI":"10.4103\/ijmy.ijmy_195_22","article-title":"Evaluation of Xpert Mycobacterium tuberculosis rifampicin for tuberculosis diagnosis in a reference laboratory","volume":"11","author":"Belotti","year":"2022","journal-title":"Int J Mycobacteriol"},{"key":"R10-20260707","doi-asserted-by":"crossref","first-page":"13","DOI":"10.4274\/mjima.galenos.2024.23055.13","article-title":"Evaluation of the Xpert MTB\/RIF test performance in the diagnosis of suspected M. tuberculosis in pulmonary and extrapulmonary clinical specimens","volume":"13","author":"Terzi","year":"2024","journal-title":"Mediterr J Infect Microb 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A systematic review and network meta-analysis","volume":"71","author":"Stagg","year":"2016","journal-title":"Thorax"}],"container-title":["The International Journal of Mycobacteriology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmy.ijmy_85_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T13:08:23Z","timestamp":1783429703000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/ijmy.ijmy_85_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijmy.ijmy_85_26","relation":{},"ISSN":["2212-5531","2212-554X"],"issn-type":[{"value":"2212-5531","type":"print"},{"value":"2212-554X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-02-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}