title: Drug resistance and genotypes of strains of Mycobacterium tuberculosis isolated from human immunodeficiency virus-infected and non-infected tuberculosis patients in Bauru, São Paulo, Brazil.
abstract: Little is known about transmission and drug resistance of tuberculosis (TB) in Bauru, State of S o Paulo. The objective of this study was to evaluate risk factors for transmission of Mycobacterium tuberculosis strains in this area. Strains were collected from patients attended at ambulatory services in the region and susceptibility towards the main first line antibiotics was determined and fingerprinting performed. A total of 57 strains were submitted to susceptibility testing: 23 (42.6%) were resistant to at least one drug while 3 (13%) were resistant against both rifampicin and isoniazide. Resistant strains had been isolated from patients that had not (n = 13) or had (n = 9) previously been submitted to anti-TB treatment, demonstrating a preoccupying high level of primary resistance in the context of the study. All strains were submitted to IS6110 restriction fragment length polymorphism (IS6110-RFLP) and double repetitive element PCR (DRE-PCR). Using IS6110-RFLP, 26.3% of the strains were clustered and one cluster of 3 patients included 2 HIV-infected individuals that had been hospitalized together during 16 days; clustering of strains of patients from the hospital was however not higher than that of patients attended at health posts. According to DRE-PCR, 55.3% belonged to a cluster, confirming the larger discriminatory power of IS6110-RFLP when compared to DRE-PCR, that should therefore be used as a screening procedure only. No clinical, epidemiological or microbiological characteristics were associated with clustering so risk factors for transmission of TB could not be defined in the present study.
authors.affiliation: Divisão de Pesquisa e Ensino, Instituto Lauro de Souza Lima, Bauru, SP, Brasil.
authors.forename: Ida Maria Foschiani Dias
authors.initials: IM
authors.lastname: Baptista
authors.forename: Maraníbia Cardoso
authors.initials: MC
authors.lastname: Oelemann
authors.forename: Diltor Vladimir Araújo
authors.initials: DV
authors.lastname: Opromolla
authors.forename: Philip Noel
authors.initials: PN
authors.lastname: Suffys
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology*; D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology*; D001938:Brazil; D016172:DNA Fingerprinting; D005260:Female; D005838:Genotype; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology; D008297:Male; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D012293:Rifampin / Q000494:pharmacology; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000382:microbiology / Q000635:transmission
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin