| Autor: |
Klopper M; Stellenbosch University, Cape Town, South Africa., Warren RM, Hayes C, Gey van Pittius NC, Streicher EM, Müller B, Sirgel FA, Chabula-Nxiweni M, Hoosain E, Coetzee G, David van Helden P, Victor TC, Trollip AP |
| Jazyk: |
angličtina |
| Zdroj: |
Emerging infectious diseases [Emerg Infect Dis] 2013 Mar; Vol. 19 (3), pp. 449-55. |
| DOI: |
10.3201/EID1903.120246 |
| Abstrakt: |
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. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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