Evaluation and genotyping of multidrug-resistant cases of tuberculosis in southern Brazil.
Sixty isolates of Mycobacterium tuberculosis identified as multidrug-resistant (MDR) at a reference laboratory in Rio Grande do Sul State during the years 1999 and 2000 were analyzed using the IS6110-restriction fragment length polymorphism (RFLP) technique. We also genotyped 202 susceptible strains to compare the genotyping results, as well as the clinical and demographic data. Spacer oligotyping (spoligotyping) analysis was performed for isolates presenting low IS6110 copy number. Patients with identical DNA pattern strains were considered clustered. From 262 isolates, 94 (36%) belonged to 20 distinct RFLP clusters, and after spoligotyping analysis, 89 of the isolates (34%) remained in cluster. MDR isolates did not differ statistically in clustering proportion from susceptible strains. A significant association between the occurrence of MDR and previous tuberculosis (TB) treatment was observed (p < 0.001), as well as failure on TB treatment (p < 0.001). Human immunodeficiency virus (HIV)-positive patients were associated with susceptible tuberculosis (p = 0.024). We also identified that unmarried patients were more likely to develop TB due to recent transmission than married patients (p < 0.005). The introduction of directly observed therapy short-course (DOTS) strategy will be important in decreasing default and failure rates and avoiding the development of new MDR strains.
Valim
Andréia Rosane de Moura
AR
Centro de Biotecnologia and Programa de Pós-graduação em Biologia Celular e Molecular, Universidade Federal do Rio Grande do Sul, Brazil.
Possuelo
Lia Gonçalves
LG
Cafrune
Patrícia Izquierdo
PI
Borges
Michele
M
Ribeiro
Marta Osório
MO
Rossetti
Maria Lúcia Rosa
ML
Zaha
Arnaldo
A
D000328:Adult; D015373:Bacterial Typing Techniques; D001938:Brazil / Q000453:epidemiology; D004251:DNA Transposable Elements / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000187:drug effects / Q000235:genetics*; D012150:Polymorphism, Restriction Fragment Length; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000382:microbiology*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000382:microbiology
D004251:DNA Transposable Elements