Minimal diversity of drug-resistant Mycobacterium tuberculosis strains, South Africa

Neel R. Gandhi, James C.M. Brust, Prashini Moodley, Darren Weissman, Moonseong Heo, Yuming Ning, Anthony P. Moll, Gerald H. Friedland, A. Willem Sturm, N. Sarita Shah

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)426-433
Number of pages8
JournalEmerging Infectious Diseases
Volume20
Issue number3
DOIs
StatePublished - Mar 2014

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Extensively Drug-Resistant Tuberculosis
Multidrug-Resistant Tuberculosis
South Africa
Mycobacterium tuberculosis
Pharmaceutical Preparations
Survival
Mortality
Quebec
Drug Resistance
Retrospective Studies
HIV
Incidence

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Epidemiology
  • Medicine(all)

Cite this

Minimal diversity of drug-resistant Mycobacterium tuberculosis strains, South Africa. / Gandhi, Neel R.; Brust, James C.M.; Moodley, Prashini; Weissman, Darren; Heo, Moonseong; Ning, Yuming; Moll, Anthony P.; Friedland, Gerald H.; Sturm, A. Willem; Shah, N. Sarita.

In: Emerging Infectious Diseases, Vol. 20, No. 3, 03.2014, p. 426-433.

Research output: Contribution to journalArticle

Gandhi, NR, Brust, JCM, Moodley, P, Weissman, D, Heo, M, Ning, Y, Moll, AP, Friedland, GH, Sturm, AW & Shah, NS 2014, 'Minimal diversity of drug-resistant Mycobacterium tuberculosis strains, South Africa', Emerging Infectious Diseases, vol. 20, no. 3, pp. 426-433. https://doi.org/10.3201/eid2003.131083
Gandhi, Neel R. ; Brust, James C.M. ; Moodley, Prashini ; Weissman, Darren ; Heo, Moonseong ; Ning, Yuming ; Moll, Anthony P. ; Friedland, Gerald H. ; Sturm, A. Willem ; Shah, N. Sarita. / Minimal diversity of drug-resistant Mycobacterium tuberculosis strains, South Africa. In: Emerging Infectious Diseases. 2014 ; Vol. 20, No. 3. pp. 426-433.
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