Sequencing of pyrazinamide resistant Mycobacterium tuberculosis isolates which carry a wild type pncA gene

In the present study, we selected 26 clinical isolates of M. tuberculosis carrying a wildtype pncA gene for an in-depth analysis of their phenotypically observed PZA resistance. 7 isolates with confirmed PZA resistance were whole genome sequenced in order to screen for alternative resistance mutations. Our findings may explain most of the phenotypic-genotypic discordances and should be considered when interpreting drug susceptibility test results as well as when evaluating and developing new DST techniques.