title: Beijing genotype of Mycobacterium tuberculosis is significantly associated with human immunodeficiency virus infection and multidrug resistance in cases of tuberculous meningitis.
abstract: 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.
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, Quan 5, Ho Chi Minh City, Vietnam. mcaws@hotmail.com
authors.forename: Maxine
authors.initials: M
authors.lastname: Caws
authors.forename: Guy
authors.initials: G
authors.lastname: Thwaites
authors.forename: Kasia
authors.initials: K
authors.lastname: Stepniewska
authors.forename: Thi Ngoc Lan
authors.initials: TN
authors.lastname: Nguyen
authors.forename: Thi Hong Duyen
authors.initials: TH
authors.lastname: Nguyen
authors.forename: Thi Phuong
authors.initials: TP
authors.lastname: Nguyen
authors.forename: Nguyet Thu Huyen
authors.initials: NT
authors.lastname: Mai
authors.forename: Minh Duy
authors.initials: MD
authors.lastname: Phan
authors.forename: Huu Loc
authors.initials: HL
authors.lastname: Tran
authors.forename: Thi Hong Chau
authors.initials: TH
authors.lastname: Tran
authors.forename: Dick
authors.initials: D
authors.lastname: van Soolingen
authors.forename: Kristin
authors.initials: K
authors.lastname: Kremer
authors.forename: Van Vinh Chau
authors.initials: VV
authors.lastname: Nguyen
authors.forename: Tran Chinh
authors.initials: TC
authors.lastname: Nguyen
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
mesh_terms: 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*