Emergence and Spread of Extensively and Totally Drug-Resistant Tuberculosis, South Africa

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Klopper, Marisa ; Warren, Robin Mark ; Hayes, Cindy ; Gey van Pittius, Nicolaas Claudius ; Streicher, Elizabeth Maria ; Müller, Borna ; Sirgel, Frederick Adriaan ; Chabula-Nxiweni, Mamisa ; Hoosain, Ebrahim ; Coetzee, Gerrit ; David van Helden, Paul ; Victor, Thomas Calldo ; Trollip, André Phillip
• Description:
  Factors driving the increase in drug-resistant tuberculosis (TB) in the Eastern Cape Province, South Africa, are not understood. A convenience sample of 309 drug-susceptible and 342 multidrug-resistant (MDR) TB isolates, collected July 2008-July 2009, were characterized by spoligotyping, DNA fingerprinting, insertion site mapping, and targeted DNA sequencing. Analysis of molecular-based data showed diverse genetic backgrounds among drug-sensitive and MDR TB sensu stricto isolates in contrast to restricted genetic backgrounds among pre-extensively drug-resistant (pre-XDR) TB and XDR TB isolates. Second-line drug resistance was significantly associated with the atypical Beijing genotype. DNA fingerprinting and sequencing demonstrated that the pre-XDR and XDR atypical Beijing isolates evolved from a common progenitor; 85% and 92%, respectively, were clustered, indicating transmission. Ninety-three percent of atypical XDR Beijing isolates had mutations that confer resistance to 10 anti-TB drugs, and some isolates also were resistant to para-aminosalicylic acid. These findings suggest the emergence of totally drug-resistant TB.
• Subjects:
  Antitubercular Agents Bacterial Proteins Catalase Cluster Analysis Communicable Diseases, Emerging Extensively Drug-Resistant Tuberculosis Genotype Humans Microbial Sensitivity Tests Mutation, Missense Research Tuberculosis, Pulmonary

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• Source:
  Emerg Infect Dis. 19(3):449-455.
• Document Type:
  Journal Article
• Place as Subject:
  South Africa
• Location:
  Africa
• Volume:
  19
• Issue:
  3
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:2ae296c69a37a16e8a12ee223501be07c8152111b9de741c49e0fe79e2e285f0
• Download URL:
  https://stacks.cdc.gov/view/cdc/18774/cdc_18774_DS1.pdf
• File Type:
  [PDF - 1.48 MB ]