TY - JOUR
T1 - Minimal diversity of drug-resistant Mycobacterium tuberculosis strains, South Africa
AU - Gandhi, Neel R.
AU - Brust, James C.M.
AU - Moodley, Prashini
AU - Weissman, Darren
AU - Heo, Moonseong
AU - Ning, Yuming
AU - Moll, Anthony P.
AU - Friedland, Gerald H.
AU - Sturm, A. Willem
AU - Shah, N. Sarita
PY - 2014/3
Y1 - 2014/3
N2 - Multidrug- (MDR) and extensively drug-resistant tuberculosis (XDR TB) are commonly associated with Beijing strains. However, in KwaZulu-Natal, South Africa, which has among the highest incidence and mortality for MDR and XDR TB, data suggest that non-Beijing strains are driving the epidemic. We conducted a retrospective study to characterize the strain prevalence among drug-susceptible, MDR, and XDR TB cases and determine associations between strain type and survival. Among 297 isolates from 2005-2006, 49 spoligotype patterns were found. Predominant strains were Beijing (ST1) among drug-susceptible isolates (27%), S/Quebec (ST34) in MDR TB (34%) and LAM4/ KZN (ST60) in XDR TB (89%). More than 90% of patients were HIV co-infected. MDR TB and XDR TB were independently associated with mortality, but TB strain type was not. We conclude that, although Beijing strain was common among drug-susceptible TB, other strains predominated among MDR TB and XDR TB cases. Drug-resistance was a stronger predictor of survival than strain type.
AB - Multidrug- (MDR) and extensively drug-resistant tuberculosis (XDR TB) are commonly associated with Beijing strains. However, in KwaZulu-Natal, South Africa, which has among the highest incidence and mortality for MDR and XDR TB, data suggest that non-Beijing strains are driving the epidemic. We conducted a retrospective study to characterize the strain prevalence among drug-susceptible, MDR, and XDR TB cases and determine associations between strain type and survival. Among 297 isolates from 2005-2006, 49 spoligotype patterns were found. Predominant strains were Beijing (ST1) among drug-susceptible isolates (27%), S/Quebec (ST34) in MDR TB (34%) and LAM4/ KZN (ST60) in XDR TB (89%). More than 90% of patients were HIV co-infected. MDR TB and XDR TB were independently associated with mortality, but TB strain type was not. We conclude that, although Beijing strain was common among drug-susceptible TB, other strains predominated among MDR TB and XDR TB cases. Drug-resistance was a stronger predictor of survival than strain type.
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U2 - 10.3201/eid2003.131083
DO - 10.3201/eid2003.131083
M3 - Article
C2 - 24565645
AN - SCOPUS:84894271387
SN - 1080-6040
VL - 20
SP - 426
EP - 433
JO - Emerging Infectious Diseases
JF - Emerging Infectious Diseases
IS - 3
ER -
