title: Identification of MDR-TB Beijing/W and other Mycobacterium tuberculosis genotypes in Nairobi, Kenya.
abstract: METHODS
  Suspected tuberculosis (TB) patients in Nairobi, Kenya.
  
  
  OBJECTIVE
  To identify the presence of multidrug-resistant (MDR) Beijing/W type and other genotypes of Mycobacterium tuberculosis.
  
  
  METHODS
  Thirty-three isolates resistant to one or more drugs (resistance ratio method), including 15 MDR isolates and 40 susceptible isolates selected at random, were analysed by dot-blot hybridisation for mutations associated with resistance to isoniazid, rifampicin, streptomycin and ethambutol. All strains were genotypically classified using spoligotyping.
  
  
  RESULTS
  Of the 33 drug-resistant isolates, 21 (64%) were from males and 12 (36%) were from females. Mutations associated with resistance to isoniazid (katG 315) and rifampicin (rpoB526, 531) were confirmed in 83.3% and 100% of the isolates, respectively, and in 87% of the MDR isolates. Mutations were detected in 25% and 71.5% of the isolates resistant to streptomycin (rpsL43) and ethambutol (embB306), respectively. No mutations were detected in drug-susceptible isolates. Spoligotyping grouped the isolates into 25 groups. Ten of these groups corresponded to previously identified strain groups, including seven families in the international database. One of these families (CAS1) comprised six (40%) of the 15 MDR isolates. Another family (Beijing) had six (8.3%) isolates, of which two (33.3%) were MDR (Beijing/W).
  
  
  CONCLUSIONS
  This study is the first in Kenya and the second in sub-Saharan Africa to report the presence of MDR Beijing/W type and other possible drug-resistant outbreak strains. Application of the molecular techniques and markers will allow us to monitor the spread of existing drug-resistant strains and the appearance of new ones.
authors.affiliation: Centre for Respiratory Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: W A
authors.initials: WA
authors.lastname: Githui
authors.forename: A M
authors.initials: AM
authors.lastname: Jordaan
authors.forename: E S
authors.initials: ES
authors.lastname: Juma
authors.forename: P
authors.initials: P
authors.lastname: Kinyanjui
authors.forename: F G
authors.initials: FG
authors.lastname: Karimi
authors.forename: J
authors.initials: J
authors.lastname: Kimwomi
authors.forename: H
authors.initials: H
authors.lastname: Meme
authors.forename: P
authors.initials: P
authors.lastname: Mumbi
authors.forename: E M
authors.initials: EM
authors.lastname: Streicher
authors.forename: R
authors.initials: R
authors.lastname: Warren
authors.forename: P D
authors.initials: PD
authors.lastname: van Helden
authors.forename: T C
authors.initials: TC
authors.lastname: Victor
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D007630:Kenya; D008297:Male; D009154:Mutation; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D010641:Phenotype; D021521:Ribotyping; D018088:Tuberculosis, Multidrug-Resistant / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents