Molecular Epidemiology and Drug Resistance of Mycobacterium tuberculosis Isolates in the Archangel Prison in Russia: Predominance of the W-Beijing Clone Family

Abstract

Prisons play a significant role in the epidemiology of drug-resistant tuberculosis. A total of 114 Mycobacterium tuberculosis isolates recovered from patients in the Archangel prison (Archangel, Russia) in 2001 were studied using restriction fragment-length polymorphism analysis and spoligotyping. Drug susceptibility was analyzed by the radiometric broth method (BACTEC; Becton Dickinson Diagnostic Systems). According to genotyping studies, 87 (76.3%) of the isolates belonged to the W-Beijing family. Nearly all (96.6%) W-Beijing isolates were part of a cluster, whereas only 25.9% of the other isolates were clustered (P<.001). The largest cluster comprised 43 patients. Multidrug resistance was high among new (34.0%) and previously treated (55.0%) cases. Resistance to ethambutol (OR, 3.4; 95% CI, 1.0-12.7; P=.03) and streptomycin (OR, 4.2; 95% CI, 1.5-11.6; P=.001) was significantly associated with infection with W-Beijing isolates. Tuberculosis due to drug-resistant W-Beijing isolates is a major problem in the Archangel prison.

Detection of Resistance to Second-Line Antituberculosis Drugs by Use of the Genotype MTBDR sl Assay: a Multicenter Evaluation and Feasibility Study

“…However, available published data show that genotypes similar to those prevalent in Estonia are widely spread across many countries of the former Soviet Union, including the Baltic States, Russia, and Central Asian countries (16,20). Since all these areas have extremely high rates of drug resistance, we believe that our study results are important for the implementation of the assay in the given settings.…”

Increased vaccine efficacy against tuberculosis of recombinant Mycobacterium bovis bacille Calmette-Guerin mutants that secrete listeriolysin

“…BCG vaccination protects newborns against conventional M. tuberculosis isolates (1,7,23,24) but has apparently lost vaccine efficacy against newly emerging isolates, notably of the M. tuberculosis Beijing/W genotype family (3,(24)(25)(26)(27)(28). In experimental animal models, BCG confers only weak protection against the clinical isolate Beijing/W (29).…”

Correlates of Mycobacterium tuberculosis infection in a prison population

“…endemic cases versus outbreaks, TB has repeatedly been shown to also involve the prison staff [6][7][8][9] and the surrounding community [2,10,11], to the extent that the World Health Organization recently stated that ''prisons act as a reservoir for TB, pumping the disease into the civilian community through staff, visitors and inadequatelytreated released inmates'' [12]. Moreover, a high rate of multidrug-resistant TB (up to 32%) has been observed in several jail settings, both in industrialised and developing countries [1,5,[13][14][15][16]. Lastly, the case-fatality rate among TB cases can reach 24% and, in some prisons, TB accounts for 50% of the overall prison deaths [17].…”