Spread of Drug-Resistant Mycobacterium tuberculosis Strains of the Beijing Genotype in the Archangel Oblast, Russia

Abstract

A collection of 119 strains of Mycobacterium tuberculosis isolated from patients with pulmonary tuberculosis in the Archangel Oblast, Russia, in 1998 and 1999 were studied by using restriction fragment length polymorphism (RFLP) analysis with the IS6110 probe and spoligotyping. Resistance of the strains to antituberculosis drugs was analyzed by the BACTEC method, and mutations associated with rifampin resistance were detected by using the Inno-LiPA Rif. TB test. RFLP analysis and spoligotyping demonstrated that 53 (44.5%) of the strains belonged to the Beijing genotype. These strains showed a significantly higher rate of resistance than M. tuberculosis strains of other genotypes circulating in the region. In particular, 43.4% of the strains of the Beijing genotype were multidrug resistant; in contrast, only 10.6% of the other strains were. Of the strains of the Beijing genotype, 92.5% were part of a cluster, while only 33.3% of the remaining strains were clustered. Analysis of the medical records of the patients demonstrated that individuals infected with a strain of the Beijing genotype were significantly more likely to be alcohol abusers and to have chronic obstructive pulmonary disease prior to the tuberculosis diagnosis. Multivariate analysis showed that both variables were independently associated with infection by strains belonging to the Beijing genotype. Our study demonstrated that strains of the Beijing genotype are an important cause of tuberculosis in the Archangel Oblast and that dissemination of these strains is associated with the high incidence of drug resistance.

Extremely high prevalence of multidrug resistant tuberculosis in Murmansk, Russia: a population-based study

“…The SIT1 spoligotype is characteristic of the Beijing/W family, which is known for its frequent association with MDR, outbreaks and high emergence worldwide. The prevalence of Beijing isolates in Russia, both in prisons and in the community, and the high rate of MDR typical for this group have been recognized in a number of studies [5,6,23,[25][26][27]. Our results are consistent with this observation and demonstrate that the Beijing genotype plays an important role in the epidemiology of MDR-TB in civilian population of this high incidence region of the North-Western Russia.…”

“…In this study, most samples grouped to the Beijing strain family (44%, n=193, SIT1, SIT255, SIT260 and SIT269). This is similar to the findings from the Archangel oblast (44.5%) [23] and to the results of a study containing 36 TB isolates from the Murmansk region, of which 47.2% represented Beijing spoligotypes [24]. The most prevalent spoligotype of this study, SIT1, included 41.9% of the isolates and 79.8% of the MDR isolates.…”

“…The high proportion (80%, n=73) of IS6110 clustered Beijing isolates, as well as the fact that one quarter of new TB cases are MDR-TB, indicates that these MDR-TB strains are actively transmitted throughout the community. The rate of IS6110 clustered MDR cases (80%) is similar to that observed in Hungary (75%) [29] but lower than in reports from Estonia (95.8%) [23,30].…”

Avaliação da resistência aos tuberculostáticos de primeira linha em cepas do complexo Mycobacterium Tuberculosis isolados no Distrito Federal

“…Há muito se sabe que o maior indicador clínico de desenvolvimento de multirresistência (MR) é o contato prévio com fármacos (Toungoussova et al, 2002;Ramaswami e Musser, 1998;Rocha et al, 2008). Assim, a MR, resistência pelo menos à H e à R, conforme o conceito internacional, é considerada um fenômeno biológico iatrogênico decorrente da aplicação inadequada dos regimes de tratamento de curta duração (Hofling et al, 2005).…”

“…A MDR-TB já é responsável por metade dos casos novos na China, Índia e Rússia. O diagnóstico lento dos casos de MDR-TB é apontado como o maior obstáculo no controle da MDR-TB (Asencios et al, 2012 proteínas codificadas, o que corresponde a 52% do seu proteoma (Toungoussova et al, 2002).…”