Spread of Drug-Resistant Pulmonary Tuberculosis in Estonia

Author:

Krüüner Annika12,Hoffner Sven E.3,Sillastu Heinart4,Danilovits Manfred4,Levina Klavdia5,Svenson Stefan B.36,Ghebremichael Solomon2,Koivula Tuija23,Källenius Gunilla23

Affiliation:

1. Institute of Microbiology, Tartu University,1 and

2. Microbiology and Tumor Biology Center, Karolinska Institute,2 and

3. Swedish Institute for Infectious Disease Control,3 Stockholm, and

4. Tartu University Lung Hospital, Clinicum,4 Tartu, and

5. Kivimäe Hospital, Tallinn,5Estonia, and

6. Department of Bacteriology, Biomedicum, Swedish University for Agricultural Sciences, Uppsala,6 Sweden

Abstract

ABSTRACT Restriction fragment length polymorphism (RFLP) analysis of 209 Mycobacterium tuberculosis clinical isolates obtained from newly detected pulmonary tuberculosis patients (151 male and 58 female; mean age, 41 years) in Estonia during 1994 showed that 61 isolates (29%) belonged to a genetically closely related group of isolates, family A, with a predominant IS 6110 banding pattern. These strains shared the majority of their IS 6110 DNA-containing restriction fragments, representing a predominant banding pattern (similarity, >65%). This family A comprised 12 clusters of identical isolates, and the largest cluster comprised 10 strains. The majority (87.5%) of all multidrug-resistant (MDR) isolates, 67.2% of all isolates with any drug resistance, but only 12% of the fully susceptible isolates of M. tuberculosis belonged to family A. These strains were confirmed by spoligotyping as members of the Beijing genotype family. The spread of Beijing genotype MDR M. tuberculosis strains was also frequently seen in 1997 to 1999. The members of this homogenous group of drug-resistant M. tuberculosis strains have contributed substantially to the continual emergence of drug-resistant tuberculosis all over Estonia.

Publisher

American Society for Microbiology

Subject

Microbiology (medical)

Reference27 articles.

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3. Transmission of tuberculosis between people of different ages in the Netherlands: an analysis using DNA fingerprinting;Borgdorff M. W.;Int. J. Tuberc. Lung Dis.,1999

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5. Molecular Epidemiology of Tuberculosis in Malaysia

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