title: Rifampin- and multidrug-resistant tuberculosis in Russian civilians and prison inmates: dominance of the beijing strain family.
abstract: Consecutive patient cultures (140) of Mycobacteriium tuberculosis were collected from five Russian civilian and prison tuberculosis laboratories and analyzed for rifampin (rpoB) and isoniazid resistance (inhA, katG, ahpC); transmission of Beijing family isolates; and the importance of prison and previous therapy in drug resistance. Rifampin, isoniazid, and multidrug resistance occurred in 58.2%, 51.6%, and 44.7% of cultures, respectively; 80% of prison cultures were rifampin resistant. Spoligotyping and variable number tandem repeat (VNTR) fingerprinting divided the isolates into 43 groups. Spoligotyping demonstrated that a high proportion (68.1%) of patients were infected with Beijing family strains and that most (69.1%) were rifampin resistant; the highest proportion (81.6%) occurred in prison. One VNTR subgroup (42435) comprised 68 (72.3%) of the Beijing isolates with a small number of IS6110 types; 50 (73.5%) were rifampin resistant. Rifampin-resistant Beijing isolates are dominant within the patient population, especially among prisoners, and threaten treatment programs.
authors.affiliation: Guy's King's amd St Thomas' Medical School, King's College Hospital, London, United Kingdom. francis.drobniewski@kcl.ac.uk
authors.forename: Francis
authors.initials: F
authors.lastname: Drobniewski
authors.forename: Yanina
authors.initials: Y
authors.lastname: Balabanova
authors.forename: Michael
authors.initials: M
authors.lastname: Ruddy
authors.forename: Laura
authors.initials: L
authors.lastname: Weldon
authors.forename: Katya
authors.initials: K
authors.lastname: Jeltkova
authors.forename: Timothy
authors.initials: T
authors.lastname: Brown
authors.forename: Nadezdna
authors.initials: N
authors.lastname: Malomanova
authors.forename: Elvira
authors.initials: E
authors.lastname: Elizarova
authors.forename: Alexander
authors.initials: A
authors.lastname: Melentyey
authors.forename: Ebgeny
authors.initials: E
authors.lastname: Mutovkin
authors.forename: Svetlana
authors.initials: S
authors.lastname: Zhakharova
authors.forename: Ivan
authors.initials: I
authors.lastname: Fedorin
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002681:China; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D018598:Minisatellite Repeats; D009154:Mutation; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D011329:Prisoners; D012293:Rifampin / Q000494:pharmacology* / Q000627:therapeutic use; D012426:Russia / Q000453:epidemiology; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents; D012293:Rifampin