Literature Review On Multi-Extensively Drug-Resistant Mycobacterium Tuberculosis Mutations: Highlighting Molecular Analysis Gaps At Tshepong NHLS Referral Laboratory.

The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) Mycobacterium tuberculosis presents a significant challenge to global public health. This study explores the sensitivity profiling of genes responsible for MDR and XDR mutations in M. tuberculosis isolates from the Tshepong National Health Laboratory Service Referral Tuberculosis Laboratory in North West. A literature review was conducted using databases such as Google Scholar, PubMed, and PubMed Central to identify relevant articles published between 2020 and 2024. The selected studies were analysed to determine the genes involved in resistance mechanisms and to develop a conceptual framework for understanding their interactions with firstand second-line anti-tuberculosis drugs. According to the literature, more than 95% of rifampicin resistance is associated with rpoB gene alterations within an 81 bp region. Additionally, isoniazid (INH) resistance is more complex and has been linked to multiple genes, particularly katG and the inhA promoter region. The reviewed studies highlight gaps in research and suggest directions for future studies to improve drug susceptibility testing, particularly in regions such as North West Province, South Africa.