Population Structure of Multi- and Extensively Drug-Resistant Mycobacterium tuberculosis Strains in South Africa

被引：50

作者：

Chihota, Violet N. ^{[1
,2
]}

Mueller, Borna ^{[1
]}

Mlambo, Charmaine K. ^{[3
,4
]}

Pillay, Manormoney ^{[5
]}

Tait, Marisa ^{[1
]}

Streicher, Elizabeth M. ^{[1
]}

Marais, Else ^{[3
,4
]}

van der Spuy, Gian D. ^{[1
]}

Hanekom, Madeleine ^{[6
]}

Coetzee, Gerrit ^{[7
]}

Trollip, Andre ^{[1
]}

Hayes, Cindy ^{[8
]}

Bosman, Marlein E. ^{[9
]}

Gey van Pittius, Nicolaas Claudius ^{[1
]}

Victor, Tommie C. ^{[1
]}

van Helden, Paul D. ^{[1
]}

Warren, Robin M. ^{[1
]}

机构：

[1] Univ Stellenbosch, DST NRF Ctr Excellence Biomed TB Res, MRC Ctr Mol & Cellular Biol, Div Mol Biol & Human Genet,Fac Hlth Sci, ZA-7600 Stellenbosch, South Africa

[2] Aurum Inst Hlth Res, Johannesburg, South Africa

[3] Natl Hlth Lab Serv, Johannesburg, South Africa

[4] Univ Witwatersrand, Johannesburg, South Africa

[5] Univ KwaZulu Natal, Dept Infect Prevent & Control, Durban, South Africa

[6] Univ Stellenbosch, Anat & Histol Dept Biomed Sci, Fac Hlth Sci, ZA-7600 Stellenbosch, South Africa

[7] Natl Hlth Lab Serv, Natl Inst Communicable Dis, Natl TB Reference Lab, Johannesburg, South Africa

[8] Port Elizabeth Cent Lab, Natl Hlth Lab Serv, Port Elizabeth, South Africa

[9] Natl Hlth Lab Serv, Cape Town, South Africa

来源：

JOURNAL OF CLINICAL MICROBIOLOGY | 2012年 / 50卷 / 03期

基金：

英国惠康基金;

关键词：

WESTERN CAPE; EPIDEMIOLOGY; EVOLUTION; FITNESS; DIAGNOSIS; DIVERSITY; TB;

D O I：

10.1128/JCM.05832-11

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Genotyping of multidrug-resistant (MDR) Mycobacterium tuberculosis strains isolated from tuberculosis ( TB) patients in four South African provinces (Western Cape, Eastern Cape, KwaZulu-Natal, and Gauteng) revealed a distinct population structure of the MDR strains in all four regions, despite the evidence of substantial human migration between these settings. In all analyzed provinces, a negative correlation between strain diversity and an increasing level of drug resistance ( from MDR-TB to extensively drug-resistant TB [XDR-TB]) was observed. Strains predominating in XDR-TB in the Western and Eastern Cape and KwaZulu-Natal Provinces were strongly associated with harboring an inhA promoter mutation, potentially suggesting a role of these mutations in XDR-TB development in South Africa. Approximately 50% of XDR-TB cases detected in the Western Cape were due to strains probably originating from the Eastern Cape. This situation may illustrate how failure of efficient health care delivery in one setting can burden health clinics in other areas.

引用

页码：995 / 1002

页数：8

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