Strains of Mycobacterium tuberculosis from Western Maharashtra, India, Exhibit a High Degree of Diversity and Strain-Specific Associations with Drug Resistance, Cavitary Disease, and Treatment Failure

被引:59
作者
Chatterjee, Anirvan [1 ]
D'Souza, Desiree [1 ]
Vira, Tina [1 ]
Bamne, Arun [3 ]
Ambe, Gurish T. [4 ]
Nicol, Mark P. [2 ]
Wilkinson, Robert J. [5 ,6 ,7 ,8 ]
Mistry, Nerges [1 ]
机构
[1] Fdn Med Res, Mumbai 400018, Maharashtra, India
[2] Univ Cape Town, Div Med Microbiol, Sch Med, ZA-7925 Cape Town, South Africa
[3] Mumbai Dist TB Control Soc 111, Mumbai 400018, Maharashtra, India
[4] BMC, Bombay 400012, Maharashtra, India
[5] Univ London Imperial Coll Sci Technol & Med, Div Med, London W2 1PG, England
[6] Univ Cape Town, Inst Infect Dis & Mol Med, ZA-7925 Cape Town, South Africa
[7] Univ Cape Town, Dept Med, Fac Hlth Sci, ZA-7925 Cape Town, South Africa
[8] Natl Inst Med Res, MRC, London NW7 1AA, England
基金
英国惠康基金;
关键词
INTERSPERSED REPETITIVE UNITS; GENETIC DIVERSITY; BEIJING GENOTYPE; PULMONARY TUBERCULOSIS; CLINICAL-SAMPLES; EPIDEMIOLOGY; MUMBAI; EVOLUTION; NUMBERS; LINEAGE;
D O I
10.1128/JCM.00430-10
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
We performed spoligotyping of Mycobacterium tuberculosis isolates from 833 systematically sampled pulmonary tuberculosis (TB) patients in urban Mumbai, India (723 patients), and adjacent rural areas in western India (110 patients). The urban cohort consisted of two groups of patients, new cases (646 patients) and first-time treatment failures (77 patients), while only new cases were recruited in the rural areas. The isolates from urban new cases showed 71% clustering, with 168 Manu1, 62 CAS, 22 Beijing, and 30 EAI-5 isolates. The isolates from first-time treatment failures were 69% clustered, with 14 Manu1, 8 CAS, 8 Beijing, and 6 EAI-5 isolates. The proportion of Beijing strains was higher in this group than in urban new cases (odds ratio [OR], 3.29; 95% confidence limit [95% CL], 1.29 to 8.14; P = 0.003). The isolates from rural new cases showed 69% clustering, with 38 Manu1, 7 CAS, and 1 EAI-5 isolate. Beijing was absent in the rural cohort. Manu1 was found to be more common in the rural cohort (OR, 0.67; 95% CL, 0.42 to 1.05; P = 0.06). In total, 71% of isolates were clustered into 58 spoligotypes with 4 predominant strains, Manu1 (26%), CAS (9%), EAI-5 (4%), and Beijing (4%), along with 246 unique spoligotypes. In the isolates from urban new cases, we found Beijing to be associated with multidrug resistance (MDR) (OR, 3.40; 95% CL, 1.20 to 9.62; P = 0.02). CAS was found to be associated with pansensitivity (OR, 1.83; 95% CL, 1.03 to 3.24; P = 0.03) and cavities as seen on chest radiographs (OR, 2.72; 95% CL, 1.34 to 5.53; P = 0.006). We recorded 239 new spoligotypes yet unreported in the global databases, suggesting that the local TB strains exhibit a high degree of diversity.
引用
收藏
页码:3593 / 3599
页数:7
相关论文
共 37 条
[1]   High incidence of the Beijing genotype among multidrug-resistant isolates of Mycobacterium tuberculosis in a tertiary care center in Mumbai, India [J].
Almeida, D ;
Rodrigues, C ;
Ashavaid, TF ;
Lalvani, A ;
Udwadia, ZF ;
Mehta, A .
CLINICAL INFECTIOUS DISEASES, 2005, 40 (06) :881-886
[2]   Incidence of multidrug-resistant tuberculosis in urban and rural India and implications for prevention [J].
Almeida, D ;
Rodrigues, C ;
Udwadia, ZF ;
Lalvani, A ;
Gothi, GD ;
Mehta, P ;
Mehta, A .
CLINICAL INFECTIOUS DISEASES, 2003, 36 (12) :E152-E154
[3]  
[Anonymous], 2008, GLOBAL TUBERCULOSIS
[4]  
[Anonymous], WHOCDSTB2000278
[5]   Characterization of predominant Mycobacterium tuberculosis strains from different subpopulations of India [J].
Arora, Jyoti ;
Singh, Urvashi Balbir ;
Suresh, Naga ;
Rana, Tanu ;
Porwal, Chhavi ;
Kaushik, Amit ;
Pande, Jitendra Nath .
INFECTION GENETICS AND EVOLUTION, 2009, 9 (05) :832-839
[6]  
BAKER JF, 1978, INTRO MED LAB TECHNO
[7]   Mycobacterium tuberculosis complex genetic diversity:: mining the fourth international spoligotyping database (SpoIDB4) for classification, population genetics and epidemiology [J].
Brudey, Karine ;
Driscoll, Jeffrey R. ;
Rigouts, Leen ;
Prodinger, Wolfgang M. ;
Gori, Andrea ;
Al-Hajoj, Sahal A. ;
Allix, Caroline ;
Aristimuno, Liselotte ;
Arora, Jyoti ;
Baumanis, Viesturs ;
Binder, Lothar ;
Cafrune, Patricia ;
Cataldi, Angel ;
Cheong, Soonfatt ;
Diel, Roland ;
Ellermeier, Christopher ;
Evans, Jason T. ;
Fauville-Dufaux, Maryse ;
Ferdinand, Severine ;
Garcia de Viedma, Dario ;
Garzelli, Carlo ;
Gazzola, Lidia ;
Gomes, Harrison M. ;
Guttierez, M. Cristina ;
Hawkey, Peter M. ;
van Helden, Paul D. ;
Kadival, Gurujaj V. ;
Kreiswirth, Barry N. ;
Kremer, Kristin ;
Kubin, Milan ;
Kulkarni, Savita P. ;
Liens, Benjamin ;
Lillebaek, Troels ;
Ly, Ho Minh ;
Martin, Carlos ;
Martin, Christian ;
Mokrousov, Igor ;
Narvskaia, Olga ;
Ngeow, Yun Fong ;
Naumann, Ludmilla ;
Niemann, Stefan ;
Parwati, Ida ;
Rahim, Zeaur ;
Rasolofo-Razanamparany, Voahangy ;
Rasolonavalona, Tiana ;
Rossetti, M. Lucia ;
Ruesch-Gerdes, Sabine ;
Sajduda, Anna ;
Samper, Sofia ;
Shemyakin, Igor G. .
BMC MICROBIOLOGY, 2006, 6 (1)
[8]   Endemic stability - a veterinary idea applied to human public health [J].
Coleman, PG ;
Perry, BD ;
Woolhouse, MEJ .
LANCET, 2001, 357 (9264) :1284-1286
[9]   Epidemiologic usefulness of spoligotyping for secondary typing of Mycobacterium tuberculosis isolates with low copy numbers of IS6110 [J].
Cronin, WA ;
Golub, JE ;
Magder, LS ;
Baruch, NG ;
Lathan, MJ ;
Mukasa, LN ;
Hooper, N ;
Razeq, JH ;
Mulcahy, D ;
Benjamin, WH ;
Bishai, WR .
JOURNAL OF CLINICAL MICROBIOLOGY, 2001, 39 (10) :3709-3711
[10]   High levels of multidrug resistant tuberculosis in new and treatment-failure patients from the Revised National Tuberculosis Control Programme in an urban metropolis (Mumbai) in Western India [J].
D'souza, Desiree T. B. ;
Mistry, Nerges F. ;
Vira, Tina S. ;
Dholakia, Yatin ;
Hoffner, Sven ;
Pasvol, Geoffrey ;
Nicol, Mark ;
Wilkinson, Robert J. .
BMC PUBLIC HEALTH, 2009, 9