Beijing and Haarlem genotypes are overrepresented among children with drug-resistant tuberculosis in the Western Cape province of South Africa
Date
2006
Authors
Marais B.J.
Victor T.C.
Hesseling A.C.
Barnard M.
Jordaan A.
Brittle W.
Reuter H.
Beyers N.
Van Helden P.D.
Warren R.M.
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Drug resistance among children with culture-confirmed tuberculosis (TB) provides an accurate measure of transmitted drug resistance within the community. We describe the genotype diversity in children with culture-confirmed TB and investigate the relationship between genotype and drug resistance. A prospective study was conducted from March 2003 through August 2005 at Tygerberg Children's Hospital, in the Western Cape Province of South Africa. All children (<13 years of age) diagnosed with culture-confirmed TB were included. Genotype analysis and phenotypic drug susceptibility testing were performed on the first culture-positive isolate from each patient. Mutation analysis was performed on all drug-resistant isolates. Spoligo-typing was successfully performed on isolates from 391/399 (98%) children diagnosed with culture-confirmed TB. Drug susceptibility testing was also performed on 391 isolates; 49 (12.5%) were resistant to isoniazid, and 20 (5.1%) of these were resistant to both isoniazid and rifampin. Beijing was the most common genotype family, identified in 130/391 (33.2%) cases, followed by LAM in 114/391 (29.2%) cases. The presence of both Beijing and Haarlem genotype families was significantly associated with drug resistance (26/49 [53.1%] versus 113/342 [33.0%]; odds ratio, 1.7; 95% confidence interval, 1.0 to 2.9). The high prevalence of Beijing and LAM in children with culture-confirmed TB reflects considerable transmission of these genotype families within the community. The overrepresentation of Beijing and Haarlem genotype families in children with drug-resistant TB demonstrates their contribution to transmitted drug resistance and their potential importance in the emergent drug-resistant TB epidemic. Copyright © 2006, American Society for Microbiology. All Rights Reserved.
Description
Keywords
isoniazid, rifampicin, tuberculostatic agent, antibiotic resistance, article, bacterial growth, bacterium contamination, bacterium culture, child, controlled study, drug sensitivity, female, gene mutation, genotype, human, infant, major clinical study, male, multidrug resistance, prevalence, priority journal, tuberculosis, drug effect, genetics, Mycobacterium tuberculosis, newborn, preschool child, South Africa, Antitubercular Agents, Child, Child, Preschool, Drug Resistance, Multiple, Bacterial, Female, Genotype, Humans, Infant, Infant, Newborn, Male, Mycobacterium tuberculosis, South Africa, Tuberculosis
Citation
Journal of Clinical Microbiology
44
10
44
10