title: Molecular characterisation of Mycobacterium tuberculosis isolates in the First National Survey of Anti-tuberculosis Drug Resistance from Venezuela.
abstract: BACKGROUND
  Molecular typing of Mycobacterium tuberculosis strains has become a valuable tool in the epidemiology of tuberculosis (TB) by allowing detection of outbreaks, tracking of epidemics, identification of genotypes and transmission events among patients who would have remained undetected by conventional contact investigation. This is the first genetic biodiversity study of M. tuberculosis in Venezuela. Thus, we investigated the genetic patterns of strains isolated in the first survey of anti-tuberculosis drug-resistance realised as part of the Global Project of Anti-tuberculosis Drug Resistance Surveillance (WHO/IUATLD).
  
  
  RESULTS
  Clinical isolates (670/873) were genotyped by spoligotyping. The results were compared with the international spoligotyping database (SpolDB4). Multidrug resistant (MDR) strains (14/18) were also analysed by IS6110-RFLP assays, and resistance to isoniazid and rifampicin was characterised. Spoligotyping grouped 82% (548/670) of the strains into 59 clusters. Twenty new spoligotypes (SITs) specific to Venezuela were identified. Eight new inter-regional clusters were created. The Beijing genotype was not found. The genetic network shows that the Latin American and Mediterranean family constitutes the backbone of the genetic TB population-structure in Venezuela, responsible of >60% of total TB cases studied. MDR was 0.5% in never treated patients and 13.5% in previously treated patients. Mutations in rpoB gene and katG genes were detected in 64% and 43% of the MDR strains, respectively. Two clusters were found to be identical by the four different analysis methods, presumably representing cases of recent transmission of MDR tuberculosis.
  
  
  CONCLUSIONS
  This study gives a first overview of the M. tuberculosis strains circulating in Venezuela during the first survey of anti-tuberculosis drug-resistance. It may aid in the creation of a national database that will be a valuable support for further studies.
authors.affiliation: Escuela de Medicina, Universidad Centroccidental Lisandro Alvarado, Venezuela. lisearistimuno@yahoo.es
authors.forename: Liselotte
authors.initials: L
authors.lastname: Aristimuño
authors.forename: Raimond
authors.initials: R
authors.lastname: Armengol
authors.forename: Alberto
authors.initials: A
authors.lastname: Cebollada
authors.forename: Mercedes
authors.initials: M
authors.lastname: España
authors.forename: Alexis
authors.initials: A
authors.lastname: Guilarte
authors.forename: Carmen
authors.initials: C
authors.lastname: Lafoz
authors.forename: María A
authors.initials: MA
authors.lastname: Lezcano
authors.forename: María J
authors.initials: MJ
authors.lastname: Revillo
authors.forename: Carlos
authors.initials: C
authors.lastname: Martín
authors.forename: Carmen
authors.initials: C
authors.lastname: Ramírez
authors.forename: Nalin
authors.initials: N
authors.lastname: Rastogi
authors.forename: Janet
authors.initials: J
authors.lastname: Rojas
authors.forename: Albina Vázques
authors.initials: AV
authors.lastname: de Salas
authors.forename: Christophe
authors.initials: C
authors.lastname: Sola
authors.forename: Sofía
authors.initials: S
authors.lastname: Samper
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology*; D003625:Data Collection; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification; D010802:Phylogeny; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D014687:Venezuela / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents