title: Spread of drug-resistant pulmonary tuberculosis in Estonia.
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 IS6110 banding pattern. These strains shared the majority of their IS6110 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.
authors.affiliation: Institute of Microbiology, Tartu University, Tartu, Estonia.
authors.forename: A
authors.initials: A
authors.lastname: Krüüner
authors.forename: S E
authors.initials: SE
authors.lastname: Hoffner
authors.forename: H
authors.initials: H
authors.lastname: Sillastu
authors.forename: M
authors.initials: M
authors.lastname: Danilovits
authors.forename: K
authors.initials: K
authors.lastname: Levina
authors.forename: S B
authors.initials: SB
authors.lastname: Svenson
authors.forename: S
authors.initials: S
authors.lastname: Ghebremichael
authors.forename: T
authors.initials: T
authors.lastname: Koivula
authors.forename: G
authors.initials: G
authors.lastname: Källenius
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology*; D015373:Bacterial Typing Techniques; D004251:DNA Transposable Elements / Q000235:genetics*; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D009841:Oligonucleotides / Q000032:analysis; D012150:Polymorphism, Restriction Fragment Length; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*
chemical_list: D000995:Antitubercular Agents; D004251:DNA Transposable Elements; D009841:Oligonucleotides