Beijing genotype of Mycobacterium tuberculosis is significantly associated with human immunodeficiency virus infection and multidrug resistance in cases of tuberculous meningitis.
Multidrug-resistant tuberculous meningitis is fatal without rapid diagnosis and use of second-line therapy. It is more common in human immunodeficiency virus (HIV)-positive patients. Beijing genotype strains of Mycobacterium tuberculosis are associated with drug resistance, particularly multidrug resistance, and their prevalence is increasing worldwide. The prevalence of Beijing genotype strains among Mycobacterium tuberculosis isolates from the cerebrospinal fluid of HIV-positive (n = 35) and HIV-negative (n = 187) patients in Ho Chi Minh City was determined. The Beijing genotype was significantly associated with HIV status (odds ratio [OR] = 2.95 [95% confidence interval {CI}, 1.38 to 6.44]; P = 0.016), resistance to any drug (OR = 3.34 [95% CI, 1.87 to 5.95]; P < 0.001) and multidrug resistance (Fisher's exact test; P = 0.001). The association of the Beijing genotype with drug resistance was independent of HIV status. This is the first report of Beijing genotype association with HIV status, which may be an association unique to tuberculous meningitis.
Caws
Maxine
M
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, Quan 5, Ho Chi Minh City, Vietnam. mcaws@hotmail.com
Thwaites
Guy
G
Stepniewska
Kasia
K
Nguyen
Thi Ngoc Lan
TN
Nguyen
Thi Hong Duyen
TH
Nguyen
Thi Phuong
TP
Mai
Nguyet Thu Huyen
NT
Phan
Minh Duy
MD
Tran
Huu Loc
HL
Tran
Thi Hong Chau
TH
van Soolingen
Dick
D
Kremer
Kristin
K
Nguyen
Van Vinh Chau
VV
Nguyen
Tran Chinh
TC
Farrar
Jeremy
J
D000293:Adolescent; D000328:Adult; D005838:Genotype; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000187:drug effects; D014390:Tuberculosis, Meningeal / Q000382:microbiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000382:microbiology*