title: Genetic diversity of Mycobacterium tuberculosis isolates from a tertiary care tuberculosis hospital in South Korea.
abstract: Tuberculosis (TB) remains an immense public health problem in the Republic of Korea despite a more than fivefold decrease in the prevalence of the disease over the last 3 decades. The rise in drug-resistant TB has compounded the situation. We analyzed 208 clinical isolates of M. tuberculosis from the National Masan Tuberculosis Hospital by spoligotyping, IS6110 restriction fragment length polymorphism (RFLP), and 24-locus-based mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing to assess the diversity and transmission dynamics of the tubercle bacilli in the Republic of Korea. The majority of the isolates (97.1%) belonged to the Beijing genotype. Cluster analysis by MIRU-VNTR yielded a low clustering rate of 22.3%, with most of the clusters comprising isolates with diverse drug resistance patterns. The discriminatory capacity of the typing methods was high for RFLP and MIRU-VNTR (allelic diversity [h] = 0.99) but low for spoligotyping (h = 0.31). Although analysis of 19 MIRU-VNTR loci was needed to achieve maximum discrimination, an informative set of 8 loci (960, 1955, 2163b, 2165, 2996, 3192, 4052, and 4348) (h = 0.98) that was able to differentiate most of the closely related strains was identified. These findings suggest that 24-locus-based MIRU-VNTR typing is a likely suitable alternative to RFLP to differentiate clinical isolates in this setting, which is dominated by M. tuberculosis Beijing strains. Within the study limits, our results also suggest that the problem of drug-resistant TB in the Republic of Korea may be largely due to acquired resistance as opposed to transmission.
authors.affiliation: Tuberculosis Research Section, Laboratory of Clinical Infectious Disease, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland 20892, USA.
authors.forename: Isdore Chola
authors.initials: IC
authors.lastname: Shamputa
authors.forename: Jongseok
authors.initials: J
authors.lastname: Lee
authors.forename: Caroline
authors.initials: C
authors.lastname: Allix-Béguec
authors.forename: Eun-Jin
authors.initials: EJ
authors.lastname: Cho
authors.forename: Ji-im
authors.initials: JI
authors.lastname: Lee
authors.forename: Vignesh
authors.initials: V
authors.lastname: Rajan
authors.forename: Eun Gae
authors.initials: EG
authors.lastname: Lee
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Min
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Carroll
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Goldfeder
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyung Seok
authors.initials: HS
authors.lastname: Kang
authors.forename: Soohee
authors.initials: S
authors.lastname: Hwang
authors.forename: Seok-Yong
authors.initials: SY
authors.lastname: Eum
authors.forename: Seung Kyu
authors.initials: SK
authors.lastname: Park
authors.forename: Hyeyoung
authors.initials: H
authors.lastname: Lee
authors.forename: Philip
authors.initials: P
authors.lastname: Supply
authors.forename: Sang-Nae
authors.initials: SN
authors.lastname: Cho
authors.forename: Laura E
authors.initials: LE
authors.lastname: Via
authors.forename: Clifton E
authors.initials: CE
authors.lastname: Barry
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques / Q000379:methods; D016000:Cluster Analysis; D016172:DNA Fingerprinting / Q000379:methods; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006763:Hospitals, Chronic Disease; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018598:Minisatellite Repeats; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D012150:Polymorphism, Restriction Fragment Length; D056910:Republic of Korea; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial