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de Val BP, Romero B, Tórtola MT, León LH, Pozo P, Mercader I, Sáez JL, Domingo M, Vidal E. Polyresistant Mycobacterium bovis Infection in Human and Sympatric Sheep, Spain, 2017-2018. Emerg Infect Dis 2021; 27:1241-1243. [PMID: 33755008 PMCID: PMC8007329 DOI: 10.3201/eid2704.204467] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The main etiologic agent of tuberculosis (TB) in livestock is Mycobacterium bovis; human TB cases caused by M. bovis are rare. Analysis of a TB outbreak caused by polyresistant M. bovis involving a human and sympatric sheep in Spain suggests local circulation of drug-resistant M. bovis strains among livestock.
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The value of the continuous genotyping of multi-drug resistant tuberculosis over 20 years in Spain. Sci Rep 2020; 10:20433. [PMID: 33235225 PMCID: PMC7686341 DOI: 10.1038/s41598-020-77249-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 11/02/2020] [Indexed: 11/16/2022] Open
Abstract
Molecular epidemiology of circulating clinical isolates is crucial to improve prevention strategies. The Spanish Working Group on multidrug resistant tuberculosis (MDR-TB) is a network that monitors the MDR-TB isolates in Spain since 1998. The aim of this study was to present the study of the MDR-TB and extensively drug-resistant tuberculosis (XDR-TB) patterns in Spain using the different recommended genotyping methods over time by a national coordinated system. Based on the proposed genotyping methods in the European Union until 2018, the preservation of one method, MIRU-VNTR, applied to selected clustered strains permitted to maintain our study open for 20 years. The distribution of demographic, clinical and epidemiological characteristics of clustered and non-clustered cases of MDR/XDR tuberculosis with proportion differences as assessed by Pearson’s chi-squared or Fisher’s exact test was compared. The differences in the quantitative variables using the Student's-t test and the Mann–Whitney U test were evaluated. The results obtained showed a total of 48.4% of the cases grouped in 77 clusters. Younger age groups, having a known TB case contact (10.2% vs 4.7%) and XDR-TB (16.5% vs 1.8%) were significantly associated with clustering. The largest cluster corresponded to a Mycobacterium bovis strain mainly spread during the nineties. A total of 68.4% of the clusters detected were distributed among the different Spanish regions and six clusters involving 104 cases were grouped in 17 and 18 years. Comparison of the genotypes obtained with those European genotypes included in The European Surveillance System (TESSy) showed that 87 cases had become part of 20 European clusters. The continuity of MDR strain genotyping in time has offered a widespread picture of the situation that allows better management of this public health problem. It also shows the advantage of maintaining one genotyping method over time, which allowed the comparison between ancient, present and future samples.
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Mycobacterium tuberculosis genotypes and predominant clones among the multidrug-resistant isolates in Spain 1998-2005. INFECTION GENETICS AND EVOLUTION 2017; 55:117-126. [PMID: 28789982 DOI: 10.1016/j.meegid.2017.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/31/2017] [Accepted: 08/03/2017] [Indexed: 11/23/2022]
Abstract
Although the incidence of tuberculosis (TB) is gradually decreasing in Spain, there is an increase in the proportion of foreign-born cases. This changing scenario is slowly shifting the local TB epidemiology from endemic to imported cases with an increased risk for multidrug-resistant (MDR) and extensively drug resistant (XDR) strains of Mycobacterium tuberculosis complex. MDR/XDR strains from Spain (n=366 MTBC isolates, 1 strain per patient) isolated between 1998 and 2005 were retained for this retrospective analysis. All strains were analyzed by spoligotyping, while 12-loci MIRU-VNTR data were available for 106 isolates from 2003 to 2005. Demographic, phylogenetic, and epidemiologic analyses using anonymized data were collected and analyzed using the SITVIT2 database. Our study provides with a first snapshot of genetic diversity of MDR/XDR-TB in several autonomous regions of Spain. It highlights significantly more of SIT1/Beijing and SIT66/BOV MDR isolates (5.7% and 7.38% respectively) and increasingly more foreign-born cases from Eastern Europe. Future studies should focus on shared genotypes between Spanish and foreign-born patients to decipher the modes of transmission and risk factors involved, and decipher the proportion of imported cases of active disease versus cases of reactivation of latent TB infection among foreign-born individuals.
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Overview on mechanisms of isoniazid action and resistance in Mycobacterium tuberculosis. INFECTION GENETICS AND EVOLUTION 2016; 45:474-492. [DOI: 10.1016/j.meegid.2016.09.004] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 09/02/2016] [Accepted: 09/03/2016] [Indexed: 12/17/2022]
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Miravet Sorribes L, Arnedo Pena A, Bellido Blasco JB, Romeu García MA, Gil Fortuño M, García Sidro P, Cortés Miró P. Outbreak of multidrug-resistant tuberculosis in two secondary schools. Arch Bronconeumol 2015; 52:70-5. [PMID: 25987369 DOI: 10.1016/j.arbres.2015.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To describe an outbreak of multidrug-resistant tuberculosis (MDR-TB) in two schools METHODS This was a prospective, observational study of an outbreak of MDR-TB in 2 schools located in the towns of Onda and Nules, in the Spanish province of Castellon, from the moment of detection in November 2008 until November 2014, including patient follow-up and contact tracing. RESULTS Five cases of MDR-TB were diagnosed. Overall attack rate was 0.9%, and among the contacts traced, 66 had latent tuberculous infection, with an infection rate of 14.4%. Molecular characterization of the 5M. tuberculosis isolates was performed by restriction fragment length polymorphism (RFLP) analysis of the IS6110 sequence. In all 5 patients, cultures were negative at 4-month follow-up, showing the efficacy of the treatment given. No recurrence has been reported to date. CONCLUSIONS In the context of globalization and the increased prevalence of MDR-TB, outbreaks such as the one presented here are only to be expected. Contact tracing, strict follow-up of confirmed cases, the availability of fast diagnostic techniques to avoid treatment delay, and chemoprophylaxis, together with the molecular characterization of strains, are still essential.
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Affiliation(s)
| | - Alberto Arnedo Pena
- Sección de Epidemiología, Centro de Salud Pública, Castellón, España; CIBER-ESP grupo 41
| | - Juan B Bellido Blasco
- Sección de Epidemiología, Centro de Salud Pública, Castellón, España; CIBER-ESP grupo 41
| | | | - María Gil Fortuño
- Sección de Microbiología, Hospital La Plana, Villarreal, Castellón, España
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Investigation of Ser315 substitutions within katG gene in isoniazid-resistant clinical isolates of Mycobacterium tuberculosis from south India. BIOMED RESEARCH INTERNATIONAL 2015; 2015:257983. [PMID: 25699262 PMCID: PMC4324114 DOI: 10.1155/2015/257983] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/20/2014] [Indexed: 11/18/2022]
Abstract
Mutation at codon 315 of katG gene is the major cause for isoniazid (INH) resistance in Mycobacterium tuberculosis (M. tuberculosis). Substitution at codon 315 of katG gene was analyzed in 85 phenotypically resistant isolates collected from various parts of southern India by direct sequencing method. The obtained results were interpreted in the context of minimum inhibitory concentration (MIC) of INH. Of the 85 phenotypically resistant isolates, 56 (66%) were also correlated by the presence of resistance mutations in the katG gene; 47 of these isolates had ACC, 6 had AAC, 2 had ATC, and one had CGC codon. The frequency of Ser315 substitution in katG gene was found to be higher (70%) amongst multidrug-resistant (MDR) strains than among non-MDR (61%) INH-resistant isolates. Further, the frequency of mutations was found to be greater (74%) in isolates with higher MIC values in contrast to those isolates with low MIC values (58%). Therefore, the study identified high prevalence of Ser315Thr substitution in katG gene of INH-resistant isolates from south India. Also, isolates harboring this substitution were found to be associated with multidrug and high level INH resistance.
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Jagielski T, Bakuła Z, Roeske K, Kamiński M, Napiórkowska A, Augustynowicz-Kopeć E, Zwolska Z, Bielecki J. Detection of mutations associated with isoniazid resistance in multidrug-resistant Mycobacterium tuberculosis clinical isolates. J Antimicrob Chemother 2014; 69:2369-75. [PMID: 24855126 DOI: 10.1093/jac/dku161] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To determine the prevalence of isoniazid resistance-conferring mutations among multidrug-resistant (MDR) isolates of Mycobacterium tuberculosis from Poland. METHODS Nine genetic loci, including structural genes (katG, inhA, ahpC, kasA, ndh, nat and mshA) and regulatory regions (i.e. the mabA-inhA promoter and oxyR-ahpC intergenic region) of 50 MDR M. tuberculosis isolates collected throughout Poland were PCR-amplified in their entirety and screened for mutations by direct sequencing methodology. RESULTS Forty-six (92%) MDR M. tuberculosis isolates had mutations in the katG gene, and the katG Ser315Thr substitution predominated (72%). Eight (16%) isolates (six with a mutated katG allele) had mutations in the inhA promoter region and two such isolates also had single inhA structural gene mutations. Mutations in the oxyR-ahpC locus were found in five (10%) isolates, of which all but one had at least one additional mutation in katG. Mutations in the remaining genetic loci (kasA, ndh, nat and mshA) were detected in 12 (24%), 4 (8%), 5 (10%) and 17 (34%) MDR isolates, respectively. All non-synonymous mutants for these genes harboured mutations in katG. One isolate had no mutations in any of the analysed loci. CONCLUSIONS This study accentuates the usefulness of katG and inhA promoter mutations as predictive markers of isoniazid resistance. Testing only for katG 315 and inhA -15 mutations would detect isoniazid resistance in 84% of the MDR M. tuberculosis sample. This percentage would increase to 96% if the sequence analysis was extended to the entire katG gene. Analysis of the remaining genetic loci did not contribute greatly to the identification of isoniazid resistance.
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Affiliation(s)
- Tomasz Jagielski
- Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096 Warsaw, Poland
| | - Zofia Bakuła
- Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096 Warsaw, Poland
| | - Katarzyna Roeske
- Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096 Warsaw, Poland
| | - Michał Kamiński
- Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096 Warsaw, Poland
| | - Agnieszka Napiórkowska
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Płocka 26, 01-138 Warsaw, Poland
| | - Ewa Augustynowicz-Kopeć
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Płocka 26, 01-138 Warsaw, Poland
| | - Zofia Zwolska
- Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Płocka 26, 01-138 Warsaw, Poland
| | - Jacek Bielecki
- Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096 Warsaw, Poland
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Borgdorff MW, van Soolingen D. The re-emergence of tuberculosis: what have we learnt from molecular epidemiology? Clin Microbiol Infect 2013; 19:889-901. [PMID: 23731470 DOI: 10.1111/1469-0691.12253] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Tuberculosis (TB) has re-emerged over the past two decades: in industrialized countries in association with immigration, and in Africa owing to the human immunodeficiency virus epidemic. Drug-resistant TB is a major threat worldwide. The variable and uncertain impact of TB control necessitates not only better tools (diagnostics, drugs, and vaccines), but also better insights into the natural history and epidemiology of TB. Molecular epidemiological studies over the last two decades have contributed to such insights by answering long-standing questions, such as the proportion of cases attributable to recent transmission, risk factors for recent transmission, the occurrence of multiple Mycobacterium tuberculosis infection, and the proportion of recurrent TB cases attributable to re-infection. M. tuberculosis lineages have been identified and shown to be associated with geographical origin. The Beijing genotype is strongly associated with multidrug resistance, and may have escaped from bacille Calmette-Guérin-induced immunity. DNA fingerprinting has quantified the importance of institutional transmission and laboratory cross-contamination, and has helped to focus contact investigations. Questions to be answered in the near future with whole genome sequencing include identification of chains of transmission within clusters of patients, more precise quantification of mixed infection, and transmission probabilities and rates of progression from infection to disease of various M. tuberculosis lineages, as well as possible variations in vaccine efficacy by lineage. Perhaps most importantly, dynamics in the population structure of M. tuberculosis in response to control measures in high-prevalence areas should be better understood.
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Affiliation(s)
- M W Borgdorff
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam and Centre for Infection and Immunity Amsterdam (CINIMA), Amsterdam, The Netherlands
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Müller B, Dürr S, Alonso S, Hattendorf J, Laisse CJM, Parsons SDC, van Helden PD, Zinsstag J. Zoonotic Mycobacterium bovis-induced tuberculosis in humans. Emerg Infect Dis 2013; 19:899-908. [PMID: 23735540 PMCID: PMC4816377 DOI: 10.3201/eid1906.120543] [Citation(s) in RCA: 234] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We aimed to estimate the global occurrence of zoonotic tuberculosis (TB) caused by Mycobacterium bovis or M. caprae infections in humans by performing a multilingual, systematic review and analysis of relevant scientific literature of the last 2 decades. Although information from many parts of the world was not available, data from 61 countries suggested a low global disease incidence. In regions outside Africa included in this study, overall median proportions of zoonotic TB of ≤1.4% in connection with overall TB incidence rates ≤71/100,000 population/year suggested low incidence rates. For countries of Africa included in the study, we multiplied the observed median proportion of zoonotic TB cases of 2.8% with the continental average overall TB incidence rate of 264/100,000 population/year, which resulted in a crude estimate of 7 zoonotic TB cases/100,000 population/year. These generally low incidence rates notwithstanding, available data indicated substantial consequences of this disease for some population groups and settings.
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Affiliation(s)
- Borna Müller
- Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.
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Buu TN, van Soolingen D, Huyen MNT, Lan NTN, Quy HT, Tiemersma EW, Kremer K, Borgdorff MW, Cobelens FGJ. Increased transmission of Mycobacterium tuberculosis Beijing genotype strains associated with resistance to streptomycin: a population-based study. PLoS One 2012; 7:e42323. [PMID: 22912700 PMCID: PMC3418256 DOI: 10.1371/journal.pone.0042323] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Accepted: 07/06/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studies have shown that the Mycobacterium tuberculosis Beijing genotype is an emerging pathogen that is frequently associated with drug resistance. This suggests that drug resistant Beijing strains have a relatively high transmission fitness compared to other drug-resistant strains. METHODS AND FINDINGS We studied the relative transmission fitness of the Beijing genotype in relation to anti-tuberculosis drug resistance in a population-based study of smear-positive tuberculosis patients prospectively recruited and studied over a 4-year period in rural Vietnam. Transmission fitness was analyzed by clustering of cases on basis of three DNA typing methods. Of 2531 included patients, 2207 (87%) were eligible for analysis of whom 936 (42%) were in a DNA fingerprint cluster. The clustering rate varied by genotype with 292/786 (37%) for the Beijing genotype, 527/802 (67%) for the East-African Indian (EAI) genotype, and 117/619 (19%) for other genotypes. Clustering was associated with the EAI compared to the Beijing genotype (adjusted odds ratio (OR(adj)) 3.4: 95% CI 2.8-4.4). Patients infected with streptomycin-resistant strains were less frequently clustered than patients infected with streptomycin-susceptible strains when these were of the EAI genotype (OR(adj) 0.6, 95% CI 0.4-0.9), while this pattern was reversed for strains of the Beijing genotype (OR(adj) 1.3, 95% CI 1.0-1.8, p for difference 0.002). The strong association between Beijing and MDR-TB (OR(adj) 7.2; 95% CI 4.2-12.3) existed only if streptomycin resistance was present. CONCLUSIONS Beijing genotype strains showed less overall transmissibility than EAI strains, but when comparisons were made within genotypes, Beijing strains showed increased transmission fitness when streptomycin-resistant, while the reverse was observed for EAI strains. The association between MDR-TB and Beijing genotype in this population was strongly dependent on resistance to streptomycin. Streptomycin resistance may provide Beijing strains with a fitness advantage over other genotypes and predispose to multidrug resistance in patients infected with Beijing strains.
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Affiliation(s)
- Tran N. Buu
- Tuberculosis Control Department, Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam
| | - Dick van Soolingen
- Laboratory for Infectious Diseases and Screening, National Institute of Public Health and The Environment, Bilthoven, The Netherlands
- Department of Medical Microbiology, University Medical Center Saint Radboud, Nijmegen, The Netherlands
| | - Mai N. T. Huyen
- Microbiology Department, Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam
| | - Nguyen T. N. Lan
- Microbiology Department, Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam
| | - Hoang T. Quy
- Medical Department, Pham Ngoc Thach Hospital, Ho Chi Minh City, Vietnam
| | - Edine W. Tiemersma
- Asia Department, KNCV Tuberculosis Foundation, The Hague, The Netherlands
- Amsterdam Institute of Global Health and Development, Amsterdam, The Netherlands
| | - Kristin Kremer
- Division of Communicable Diseases, Health Security & Environment,World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Martien W. Borgdorff
- Infectious Diseases Cluster, Amsterdam Municipal Health Service, Amsterdam, The Netherlands
| | - Frank G. J. Cobelens
- Amsterdam Institute of Global Health and Development, Amsterdam, The Netherlands
- Department of Global Health, Academic Medical Center, Amsterdam, The Netherlands
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Gavín P, Iglesias MJ, Jiménez MS, Rodríguez-Valín E, Ibarz D, Lezcano MA, Revillo MJ, Martín C, Samper S. Long-term molecular surveillance of multidrug-resistant tuberculosis in Spain. INFECTION GENETICS AND EVOLUTION 2012; 12:701-10. [DOI: 10.1016/j.meegid.2011.05.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 05/18/2011] [Accepted: 05/18/2011] [Indexed: 10/18/2022]
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Garzelli C, Rindi L. Molecular epidemiological approaches to study the epidemiology of tuberculosis in low-incidence settings receiving immigrants. INFECTION GENETICS AND EVOLUTION 2012; 12:610-8. [DOI: 10.1016/j.meegid.2011.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 10/17/2011] [Accepted: 10/18/2011] [Indexed: 10/15/2022]
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Iñigo J, García de Viedma D, Arce A, Palenque E, Herranz M, Rodríguez E, Ruiz-Serrano MJ, Bouza E, Chaves F. Differential findings regarding molecular epidemiology of tuberculosis between two consecutive periods in the context of steady increase of immigration. Clin Microbiol Infect 2012; 19:292-7. [PMID: 22404140 DOI: 10.1111/j.1469-0691.2012.03794.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The demographic characteristics of the population of Madrid, with a steady increase in immigrants, from 4.7% in 1998 to 17.4% in 2007, provide an opportunity to study in depth the transmission of TB. Our aim was to compare two 3-year longitudinal molecular studies of TB to define transmission patterns and predictors of clustering. Two prospective population-based molecular and epidemiological studies (2002-2004 and 2005-2007) of TB patients were conducted in nine urban districts in Madrid using the same methodology. During the period 2002-2007, 2248 cases of TB were reported, and the incidence decreased from 23.5 per 100,000 in 2002 to 20.8 in 2007 (p <0.001). A total of 1269 isolates were molecularly characterized and included in the study. The comparison between the two periods showed that the percentage of foreign-born patients among TB cases increased from 36.2% to 45.7% (p <0.001). Furthermore, the percentage of clustered cases decreased (36.6% vs. 30.6%; p 0.028), and this decline was associated with a decrease of clustered cases among men and people under 35 years. We also observed a decrease in cases belonging to clusters containing ≥ 6 people (14.2% vs. 8.2%; p <0.001), and in cases belonging to mixed clusters containing Spanish-born and foreign-born patients (18.5% vs. 11.1%, p <0.001). Our molecular epidemiology study provides clues to interpret the decrease in the incidence of TB in a context of steady increase of immigration. In our region, the decrease in the incidence of TB can be explained predominantly as a result of a decline in recent transmission.
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Affiliation(s)
- J Iñigo
- Consejería de Sanidad, Comunidad de Madrid, Madrid, Spain
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15
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He GX, Wang HY, Borgdorff MW, van Soolingen D, van der Werf MJ, Liu ZM, Li XZ, Guo H, Zhao YL, Varma JK, Tostado CP, van den Hof S. Multidrug-resistant tuberculosis, People's Republic of China, 2007-2009. Emerg Infect Dis 2012; 17:1831-8. [PMID: 22000352 PMCID: PMC3310678 DOI: 10.3201/eid1710.110546] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Early detection, effective treatment, and infection control measures are needed to reduce transmission. We conducted a case–control study to investigate risk factors for multidrug-resistant tuberculosis (MDR TB) in the People’s Republic of China. Genotyping analysis was used to estimate the percentage of cases from recent transmission among 100 MDR TB case-patients hospitalized during April 2007–July 2009. Molecular subtyping of isolates showed that 41% of MDR TB strains clustered. Beijing genotype was found in 94% of the MDR TB isolates and 79% of the pan-susceptible isolates. In multivariate analysis, MDR TB was independently associated with Beijing genotype, retreatment for TB, symptoms lasting >3 months before first evaluation at the hospital, lack of health insurance, and being a farmer (vs. being a student). MDR TB was associated with Beijing genotype and lower socioeconomic status. A large percentage of MDR TB cases seemed to result from recent transmission. Early detection, effective treatment, and infection control measures for MDR TB are needed to reduce transmission.
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Affiliation(s)
- Guang Xue He
- Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
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Rapid test for identification of a highly transmissible Mycobacterium tuberculosis Beijing strain of sub-Saharan origin. J Clin Microbiol 2011; 50:516-8. [PMID: 22116140 DOI: 10.1128/jcm.06314-11] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The development of a rapid test to identify Mycobacterium tuberculosis Beijing isolates and specifically strain GC1237, coming from a sub-Saharan country, is needed due to its alarming wide spread on Gran Canaria Island (Spain). A rapid test that detects IS6110 present between dnaA and dnaN in the Beijing strains and in a specific site for GC1237 (Rv2180c) has been developed. This test would be a useful tool in the surveillance of subsequent cases.
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Alonso M, Navarro Y, Barletta F, Martínez Lirola M, Gotuzzo E, Bouza E, García de Viedma D. A novel method for the rapid and prospective identification of Beijing Mycobacterium tuberculosis strains by high-resolution melting analysis. Clin Microbiol Infect 2011; 17:349-57. [PMID: 20384709 DOI: 10.1111/j.1469-0691.2010.03234.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Genotypic analysis of Mycobacterium tuberculosis (MTB) has enabled the definition of several lineages. The Beijing family, which is considered highly virulent and transmissible, has been associated with resistance in certain settings and involved in severe outbreaks, making it one of the most closely-monitored lineages. Therefore, rapid prospective identification of Beijing MTB strains could be relevant. In the present study, we evaluate a real-time PCR followed by high-resolution melting (HRM) based on the identification of a single nucleotide polymorphism (SNP) in the Rv2629 gene which defines Beijing lineage (A191C for Beijing genotype and A191A for non-Beijing genotype). This combined methodology efficiently differentiated Beijing and non-Beijing strains in 100% of the isolates from a collection of reference strains without requiring specific DNA probes. Additionally, HRM was able to assign a Beijing/non-Beijing genotype in 90.9% of the respiratory specimens assayed. Its applicability was tested on a Peruvian sample of circulating MTB strains, in which it identified 10.7% as belonging to the Beijing genotype; this proportion reached 20% in the North Lima area. HRM analysis of the A191C SNP is a rapid, reliable, and sensitive method for the efficient prospective survey of high-risk Beijing MTB strains, even in developing settings where MTB culture is often not available.
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Affiliation(s)
- M Alonso
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorìo Marañón, Madrid, Spain
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Cameo MI, Lezcano MA, Samper S, Revillo MJ. Detección de Mycobacterium tuberculosis multirresistente en un paciente pediátrico con coroiditis. Enferm Infecc Microbiol Clin 2010; 28:560-2. [DOI: 10.1016/j.eimc.2009.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Revised: 10/13/2009] [Accepted: 10/19/2009] [Indexed: 11/24/2022]
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Spoligotype-based comparative population structure analysis of multidrug-resistant and isoniazid-monoresistant Mycobacterium tuberculosis complex clinical isolates in Poland. J Clin Microbiol 2010; 48:3899-909. [PMID: 20810763 DOI: 10.1128/jcm.00572-10] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The spoligotyping-based population structure of multidrug-resistant (MDR) Mycobacterium tuberculosis strains isolated in Poland (n = 46), representing all culture-positive MDR tuberculosis (MDR-TB) cases, was compared to that of isoniazid (INH)-monoresistant strains (n = 71) isolated in 2004. The latter data set from a previous study (E. Augustynowicz-Kopeć, T. Jagielski, and Z. Zwolska, J. Clin. Microbiol. 2008, 46:4041-4044) represented 87% of all INH-monoresistant strains. The clustering rates and genotypic-diversity indexes for the 2 subpopulations were not significantly different (P = 0.05). The results were entered in the SITVIT2 database to assign specific shared type designations, corresponding genotypic lineages, and geographical distributions and compared to available data from neighboring countries (Germany, n = 704; Czech Republic, n = 530; Sweden, n = 379; Kaliningrad, Russia, n = 90) and strains from previous studies in Poland (n = 317). MDR strains resulted in 27 patterns (20 unique strains within the study and 7 clusters containing 2 to 6 isolates per cluster with a clustering rate of 56.5%) and belonged to the following genotypic lineages: ill-defined T family (28.3%), Haarlem (17.4%), Latin American and Mediterranean (LAM) (13%), Beijing (8.7%), S family (4.35%), and the X clade (2.17%). Comparison of the genetic structure of the MDR strains with that of INH-monoresistant strains showed that a total of 9 patterns were shared by both groups; these represented 1/3 of the MDR strains and 2/3 of the INH-monoresistant strains. Interestingly, 76.1% of the MDR isolates and 71.8% of the INH-resistant isolates yielded spoligotypes that were previously reported from Poland. The observation that nearly half of the spoligotypes identified among both MDR (48.1%) and INH-monoresistant (43.3%) M. tuberculosis isolates were present in Poland's neighboring countries suggested that a significant proportion of MDR and INH-resistant TB cases in Poland were caused by strains actively circulating in Poland or its neighbors. Our results corroborate the leading role of the T and Haarlem genotypes in the epidemiology of drug-resistant TB in Poland. Nevertheless, the LAM and Beijing family strains that infected, correspondingly, 13% and 9% of patients with MDR-TB were absent among the strains from patients with INH-monoresistant TB, suggesting that a proportion of MDR-TB cases in Poland are due to ongoing transmission of MDR clones exhibiting specific genotypes. Study of the population genetic relationships between MDR and INH-monoresistant strains by drawing minimum spanning trees showed that ill-defined T1 sublineage strains (1/3 of all INH-monoresistant strains), represented by its prototype, SIT53, constituted the central node of the tree, followed by strains belonging to the well-defined H3, H1, and S subgroups. However, the MDR group, in addition, contained LAM (n = 6) and Beijing (n = 4) lineage isolates. With the exception of the 4 Beijing lineage strains in the latter group and a single orphan isolate in the INH-monoresistant group, none of the remaining 112/117 isolates belonged to principal genetic group 1 (PGG1) in our study. Given the high rate of clustering and the near absence of immigrants in the study, the persistence of MDR-TB in Poland seems to result from active transmission of MDR strains within the autochthonous population, the bulk of it caused by evolutionarily recent tubercle bacilli.
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Murcia MI, Manotas M, Jiménez YJ, Hernández J, Cortès MIC, López LE, Zozio T, Rastogi N. First case of multidrug-resistant tuberculosis caused by a rare “Beijing-like” genotype of Mycobacterium tuberculosis in Bogotá, Colombia. INFECTION GENETICS AND EVOLUTION 2010; 10:678-81. [DOI: 10.1016/j.meegid.2010.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2009] [Revised: 03/19/2010] [Accepted: 03/23/2010] [Indexed: 10/19/2022]
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Alonso M, Alonso Rodriguez N, Garzelli C, Martínez Lirola M, Herranz M, Samper S, Ruiz Serrano MJ, Bouza E, García de Viedma D. Characterization of Mycobacterium tuberculosis Beijing isolates from the Mediterranean area. BMC Microbiol 2010; 10:151. [PMID: 20500810 PMCID: PMC2894025 DOI: 10.1186/1471-2180-10-151] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Accepted: 05/25/2010] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The Beijing lineage of Mycobacterium tuberculosis is causing concern due to its global distribution and its involvement in severe outbreaks. Studies focused on this lineage are mainly restricted to geographical settings where its prevalence is high, whereas those in other areas are scarce. In this study, we analyze Beijing isolates in the Mediterranean area, where this lineage is not prevalent and is mainly associated with immigrant cases. RESULTS Only 1% (N = 26) of the isolates from two population-based studies in Spain corresponded to Beijing strains, most of which were pan-susceptible and from Peruvian and Ecuadorian patients. Restriction fragment length polymorphism typing with the insertion sequence IS6110 identified three small clusters (2-3 cases). Mycobacterial interspersed repetitive unit-variable number tandem repeat typing (MIRU-15) offered low discriminatory power, requiring the introduction of five additional loci. A selection of the Beijing isolates identified in the Spanish sample, together with a sample of Beijing strains from Italy, to broaden the analysis context in the Mediterranean area, were assayed in an infection model with THP-1 cells. A wide range of intracellular growth rates was observed with only two isolates showing an increased intracellular replication, in both cases associated with contained production of TNF-alpha. No correlation was observed between virulence and the Beijing phylogenetic group, clustered/orphan status, or resistance. The Beijing strain responsible for extensive spread on Gran Canaria Island was also identified in Madrid, but did not lead to secondary cases and did not show high infectivity in the infection model. CONCLUSIONS The Beijing lineage in our area is a non-homogeneous family, with only certain highly virulent representatives. The specific characterization of Beijing isolates in different settings could help us to accurately identify the virulent representatives before making general assumptions about this lineage.
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Affiliation(s)
- M Alonso
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital Gregorio Marañón, Madrid, Spain
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Gavín P, Iglesias MJ, Jiménez MS, Herrera-Leon L, Rodríguez-Valín E, Rastogi N, March J, González-Palacios R, Palenque E, Ayarza R, Hurra E, Campos-Herrero I, Vitoria MA, Lezcano MA, Revillo MJ, Martin C, Samper S. Multidrug-resistant Mycobacterium tuberculosis strain from Equatorial Guinea detected in Spain. Emerg Infect Dis 2010; 15:1858-60. [PMID: 19891888 PMCID: PMC2857231 DOI: 10.3201/eid1511.090449] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Shamaei M, Marjani M, Baghaei P, Chitsaz E, Rezaei Tabar E, Abrishami Z, Tabarsi P, Mansouri D, Masjedi MR. Drug abuse profile - patient delay, diagnosis delay and drug resistance pattern - among addict patients with tuberculosis. Int J STD AIDS 2009; 20:320-3. [PMID: 19386968 DOI: 10.1258/ijsa.2008.008299] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Socioeconomic problems limit the access of drug users to health-care services. This descriptive cross-sectional study was carried out by making use of the medical records of new case tuberculosis (TB) patients hospitalized at Masih Daneshvari Hospital, the national referral centre in Iran, from 2003 to 2006. Demographic and personal characteristics of the patients and type of disease were collected and categorized. Of the 944 patients with confirmed TB, 143 (15.1%) were drug users, among whom 140 (97.9%) were men with just three women drug users. The mean age of the drug users group was 43.04 +/- 13.81 years. The type of drug used was opium in 100 cases (69.9%), heroin in 29 (20.3%), opium and heroin together in four (2.8%) and all three, opium, heroin and crack, in two (1.4%). For 238 high-risk patients, an HIV test was performed and HIV infection was confirmed in 33 cases. Patient delay was longer in drug users (P = 0.000) against other patients, whereas diagnosis delay was shorter (P = 0.007). Drug susceptibility tests were performed for 515 patients with positive cultures. One hundred and thirty-three (14.1%) were found to have 'any resistance' to anti-TB drugs, and 10 (1.1%) individuals had multidrug-resistant TB. Twenty-six (19.5%) of the individuals who showed resistance to first-line agents were drug users. There was no significant relation between drug resistance and drug use (P = 0.4). In conclusion, it seems that active case finding for TB and HIV in addict cases must be contained in harm reduction packages. Moreover, the manifestations of the disease should be considered seriously regardless of attributing them to drug use.
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Affiliation(s)
- M Shamaei
- Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Disease, Masih Daneshvari University Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Alcaide F, Santín M. [Multidrug-resistant tuberculosis]. Enferm Infecc Microbiol Clin 2009; 26 Suppl 13:54-60. [PMID: 19100168 DOI: 10.1157/13128781] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The emergence and spread of Mycobacterium tuberculosis strains resistant to multiple drugs represent a threat for global tuberculosis control. The World Health Organization (WHO) estimates that almost 500,000 cases of M. tuberculosis resistant to isoniazid and rifampicin (multidrug-resistant, or MDR-TB), at least, emerged in 2006. In addition, new cases of extensively drug-resistant tuberculosis (XDR-TB), defined as MDR-TB with resistance to a fluoroquinolone and at least one second line injectable agent, have been reported in 45 countries in all five continents. Multidrug-resistant tuberculosis is an emerging problem in Spain but the impact of this disease is limited: the WHO estimates that 0.1% of new cases of tuberculosis and 4.3% of previously treated cases are MDR-TB. Treatment of MDR-TB is especially complicated, since this disease requires the use of drugs that are less effective and more toxic, requiring treatment to be administered over longer periods and severely reducing the probability of success. This situation poses a serious problem for low income countries, especially those with a high prevalence of human immunodeficiency virus type 1 (HIV-1) infection. MDR-TB and XDR-TB are also of special concern in wealthy countries, due to mass immigration. Therefore, tuberculosis resistant to multiple drugs should be given high priority in global public health and biomedical research.
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Affiliation(s)
- Fernando Alcaide
- Servicio de Microbiología, IDIBELL-Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
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Single-Nucleotide Polymorphism in Two Representative Multidrug-Resistant
Mycobacterium bovis
Isolates Collected from Patients in a Spanish Hospital Harboring a Human Infection Outbreak. J Clin Microbiol 2008; 46:826-7. [DOI: 10.1128/jcm.00193-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Asensio JAG, Arbués A, Pérez E, Gicquel B, Martin C. Live tuberculosis vaccines based onphoPmutants: a step towards clinical trials. Expert Opin Biol Ther 2008; 8:201-11. [DOI: 10.1517/14712598.8.2.201] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Changes in the incidence of tuberculosis in a cohort of HIV-seroconverters before and after the introduction of HAART. AIDS 2007; 21:2521-7. [PMID: 18025889 DOI: 10.1097/qad.0b013e3282f1c933] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To analyse incidence and determinants of tuberculosis in HIV-seroconverters before and after the introduction of HAART. METHODS Data from a multicenter cohort study of 2238 HIV-seroconverters between the 1980s and 2004 were analysed and censored by December 2004. Calendar year at risk intervals were pre-1992, 1992-1996 and 1997-2004. Incident tuberculosis was calculated as cases per 1000 person-years (p-y). Survival analyses using Kaplan-Meier and multivariate Cox regression allowing for late-entry were used. Proportional hazards assumptions were checked with tests based on Schoenfeld residuals. RESULTS Overall, 173 (7.7%) patients developed tuberculosis over 23 698 p-y at a rate of 7.3 cases per 1000 p-y [95% confidence interval (CI), 6.3-8.5]. Incident tuberculosis was higher in intravenous drug-users (IDUs), 12.3 per 1000 p-y compared with persons infected sexually, 3.8 per 1000 p-y (P < 0.001), and persons with clotting disorders (PCD), 2.7 per 1000 p-y (P < 0.001). A decreasing tuberculosis incidence trend was observed from 1995 in all categories. Highest tuberculosis rates, 44 per 1000 p-y, were observed prior to 1997 in IDUs infected with HIV for 11 years. In multivariable analyses women were less likely to develop tuberculosis [relative hazard (RH), 0.62; 95% CI, 0.41-0.96; P < 0.05) and IDUs were more likely to develop tuberculosis (RH, 3.0; 95% CI, 1.72-5.26, P < 0.001). In the HAART era, the hazard of developing tuberculosis was 70% lower (RH, 0.31; 95% CI, 0.17-0.54; P < 0.001). Before 1997, the risk of tuberculosis increased with time since HIV seroconversion, whereas it remained nearly constant in the HAART era. CONCLUSIONS Since the mid-1990s important decreases in tuberculosis have been observed in HIV-seroconverters that probably reflect the impact of both HAART and tuberculosis control programmes.
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Romero B, Aranaz A, Bezos J, Alvarez J, de Juan L, Tariq Javed M, Mateos A, Gómez-Mampaso E, Domínguez L. Drug susceptibility of Spanish Mycobacterium tuberculosis complex isolates from animals. Tuberculosis (Edinb) 2007; 87:565-71. [PMID: 17900988 DOI: 10.1016/j.tube.2007.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Revised: 08/10/2007] [Accepted: 08/15/2007] [Indexed: 10/22/2022]
Abstract
Mycobacterium bovis and Mycobacterium caprae are zoonotic bacteria that cause tuberculosis with several clinical manifestations. We have evaluated the susceptibility to anti-tuberculosis drugs of a panel of Spanish isolates of animal origin. The analysis of the sequence of the main genes involved in resistance was performed in 41 M. bovis and five M. caprae. The katG, inhA, rpsL, embB and gyrA genes had single nucleotide polymorphisms, not previously described in other organisms of the complex. Thirty-two M. bovis and three M. caprae isolates were tested for susceptibility to isoniazid (INH), rifampin, streptomycin, ethambutol, and ofloxacin using the standard proportion method. The results revealed that the isolates were sensitive to the five drugs. However, interference caused by sodium pyruvate in the INH test was detected: 94.3% grew at 0.2 microg INH/ml and 68.6% grew at 1 microg INH/ml. In the medium without pyruvate, 34.3% of the isolates did not grow whereas growth of the others was poor and slow. Nine M. bovis isolates were also tested by ESP Culture System II test and were sensitive to INH. The susceptibility of M. bovis to INH cannot be reliably determined using the standard proportion method due to the M. bovis growth requirements and the interference of pyruvate with INH.
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Affiliation(s)
- Beatriz Romero
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Aristimuño L, Armengol R, Cebollada A, España M, Guilarte A, Lafoz C, Lezcano MA, Revillo MJ, Martín C, Ramírez C, Rastogi N, Rojas J, de Salas AV, Sola C, Samper S. Molecular characterisation of Mycobacterium tuberculosis isolates in the First National Survey of Anti-tuberculosis Drug Resistance from Venezuela. BMC Microbiol 2006; 6:90. [PMID: 17032442 PMCID: PMC1621067 DOI: 10.1186/1471-2180-6-90] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Accepted: 10/10/2006] [Indexed: 12/02/2022] Open
Abstract
Background Molecular typing of Mycobacterium tuberculosis strains has become a valuable tool in the epidemiology of tuberculosis (TB) by allowing detection of outbreaks, tracking of epidemics, identification of genotypes and transmission events among patients who would have remained undetected by conventional contact investigation. This is the first genetic biodiversity study of M. tuberculosis in Venezuela. Thus, we investigated the genetic patterns of strains isolated in the first survey of anti-tuberculosis drug-resistance realised as part of the Global Project of Anti-tuberculosis Drug Resistance Surveillance (WHO/IUATLD). Results Clinical isolates (670/873) were genotyped by spoligotyping. The results were compared with the international spoligotyping database (SpolDB4). Multidrug resistant (MDR) strains (14/18) were also analysed by IS6110-RFLP assays, and resistance to isoniazid and rifampicin was characterised. Spoligotyping grouped 82% (548/670) of the strains into 59 clusters. Twenty new spoligotypes (SITs) specific to Venezuela were identified. Eight new inter-regional clusters were created. The Beijing genotype was not found. The genetic network shows that the Latin American and Mediterranean family constitutes the backbone of the genetic TB population-structure in Venezuela, responsible of >60% of total TB cases studied. MDR was 0.5% in never treated patients and 13.5% in previously treated patients. Mutations in rpoB gene and katG genes were detected in 64% and 43% of the MDR strains, respectively. Two clusters were found to be identical by the four different analysis methods, presumably representing cases of recent transmission of MDR tuberculosis. Conclusion This study gives a first overview of the M. tuberculosis strains circulating in Venezuela during the first survey of anti-tuberculosis drug-resistance. It may aid in the creation of a national database that will be a valuable support for further studies.
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Affiliation(s)
- Liselotte Aristimuño
- Escuela de Medicina, Universidad Centroccidental Lisandro Alvarado, Venezuela
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, España
| | - Raimond Armengol
- Programa Nacional Integrado de Control de la Tuberculosis, MSDS, Venezuela
| | - Alberto Cebollada
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, España
| | - Mercedes España
- Programa Nacional Integrado de Control de la Tuberculosis, MSDS, Venezuela
| | - Alexis Guilarte
- Programa Nacional Integrado de Control de la Tuberculosis, MSDS, Venezuela
| | - Carmen Lafoz
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, España
| | - María A Lezcano
- Servicio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - María J Revillo
- Servicio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - Carlos Martín
- Grupo de Genética de Micobacterias, Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, España
| | - Carmen Ramírez
- Programa Nacional Integrado de Control de la Tuberculosis, MSDS, Venezuela
| | - Nalin Rastogi
- Unité de la Tuberculose et des Mycobactéries, Institut Pasteur, Pointe-à-Pitre, Guadeloupe
| | - Janet Rojas
- Programa Nacional Integrado de Control de la Tuberculosis, MSDS, Venezuela
| | | | - Christophe Sola
- Unité de la Tuberculose et des Mycobactéries, Institut Pasteur, Pointe-à-Pitre, Guadeloupe
| | - Sofía Samper
- Servicio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, España
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van Doorn HR, de Haas PEW, Kremer K, Vandenbroucke-Grauls CMJE, Borgdorff MW, van Soolingen D. Public health impact of isoniazid-resistant Mycobacterium tuberculosis strains with a mutation at amino-acid position 315 of katG: a decade of experience in The Netherlands. Clin Microbiol Infect 2006; 12:769-75. [PMID: 16842572 DOI: 10.1111/j.1469-0691.2006.01495.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A previous limited study demonstrated that Mycobacterium tuberculosis isolates with a mutation at amino-acid position 315 of katG (Delta315) exhibited high-level resistance to isoniazid and were more frequently resistant to streptomycin. In the present study, isoniazid-resistant M. tuberculosis isolates from 8,332 patients in The Netherlands (1993-2002) were screened for the Delta315 mutation. Isoniazid resistance was found in 592 (7%) isolates, of which 323 (55%) carried Delta315. IS6110 restriction fragment length polymorphism analysis showed that Delta315 isolates occurred in clusters, suggesting recent transmission, at the same frequency as isoniazid-susceptible isolates. In contrast, other isoniazid-resistant isolates clustered significantly less frequently. Delta315 isolates were high-level isoniazid-resistant, streptomycin-resistant and multidrug-resistant significantly more often, and may have a greater impact on public health, than other isoniazid-resistant isolates.
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Affiliation(s)
- H R van Doorn
- Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
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Bran CM, Caylá JA, Domínguez Á, Camps N, Godoy P, Orcau A, Barrabeig I, Alcaide J, Altet N, Álvarez P. Estudio de los brotes de tuberculosis que han generado informes epidemiológicos en Cataluña (1998-2002). Arch Bronconeumol 2006. [DOI: 10.1157/13089536] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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