Yale University

Minimal Diversity of Drug-Resistant Mycobacterium tuberculosis Strains, South Africa

TitleMinimal Diversity of Drug-Resistant Mycobacterium tuberculosis Strains, South Africa
Publication TypeJournal Article
Year of Publication2014
AuthorsGandhi, Neel R., James C. M. Brust, Prashini Moodley, Darren Weissman, Moonseong Heo, Yuming Ning, Anthony P. Moll, Gerald H. Friedland, Willem A. Sturm, and Sarita N. Shah
JournalEmerging infectious diseases
Date Published2014 Mar
AbstractMultidrug- (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.
Alternate JournalEmerging Infect. Dis.

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