@article {3891,
	title = {Minimal Diversity of Drug-Resistant Mycobacterium tuberculosis Strains, South Africa},
	journal = {Emerging infectious diseases},
	volume = {20},
	year = {2014},
	month = {2014 Mar},
	pages = {394-401},
	abstract = {Multidrug- (MDR) and extensively drug-resistant tuberculosis (XDR TB) are commonly associated with Beijing strains. However, in KwaZulu-Natal, South Africa, which has among the highest incidence and mortality for MDR and XDR TB, data suggest that non-Beijing strains are driving the epidemic. We conducted a retrospective study to characterize the strain prevalence among drug-susceptible, MDR, and XDR TB cases and determine associations between strain type and survival. Among 297 isolates from 2005-2006, 49 spoligotype patterns were found. Predominant strains were Beijing (ST1) among drug-susceptible isolates (27\%), S/Quebec (ST34) in MDR TB (34\%) and LAM4/KZN (ST60) in XDR TB (89\%). More than 90\% of patients were HIV co-infected. MDR TB and XDR TB were independently associated with mortality, but TB strain type was not. We conclude that, although Beijing strain was common among drug-susceptible TB, other strains predominated among MDR TB and XDR TB cases. Drug-resistance was a stronger predictor of survival than strain type.},
	issn = {1080-6059},
	doi = {10.3201/eid2003.131083},
	author = {Gandhi, Neel R and Brust, James C M and Moodley, Prashini and Weissman, Darren and Heo, Moonseong and Ning, Yuming and Moll, Anthony P and Friedland, Gerald H and Sturm, A Willem and Shah, N Sarita}
}
