title: [MDR, pre-XDR and XDR drug-resistant tuberculosis in Poland in 2000-2009].
abstract: BACKGROUND
  Tuberculosis (TB) is a curable disease and its spread can be prevented by using appropriate diagnostic methods and effective treatment. The obstacle to the rapid eradication of the disease from a population may be strains resistant to essential and most effective antibiotics. In many places in the world MDR, pre-XDR and XDR-TB was reported. These forms of TB do not respond to the standard six-month treatment with first-line anti-TB drugs and the therapy should be conducted two years or more with drugs that are less potent, more toxic and much more expensive.
  
  
  METHODS
  This study included MDR-TB strains isolated from 297 patients in 2000-2009. To determine the XDR-TB population structure, the 19 isolates were genotyped by spoligotyping and MIRU-VNTR (mycobacterial interspersed repetitive units-variable number of tandem repeats) method.
  
  
  RESULTS
  Among 297 MDR-TB cases, 36 (12.1%) were pre-extensively drug-resistant (pre-XDR), 19 (6.4%) were XDR and 1 (0.3%) was pre-totally drug-resistant (pre-TDR). Four of the 19 XDR isolates exhibit a unique spoligopattern, while the rest 15 belonged to one of 5 clusters. The MIRU-VNTR analysis reduced the number of clustered isolates to 11.
  
  
  CONCLUSIONS
  The study documented the emergence of pre-extensively and extensively drug-resistant tuberculosis in Poland among patients with multidrug-resistant TB. Genotyping methods showed clonal similarity among XDR strains and may suggest the possible transmission among patients with newly diagnosed and with recurrent TB.
authors.affiliation: Zakład Mikrobiologii, Instytut Gruźlicy i Chorób Płuc w Warszawie Kierownik, ul. Płocka 26, Warsaw.
authors.forename: Monika
authors.initials: M
authors.lastname: Kozińska
authors.forename: Anna
authors.initials: A
authors.lastname: Brzostek
authors.forename: Dorota
authors.initials: D
authors.lastname: Krawiecka
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Rybczyńska
authors.forename: Zofia
authors.initials: Z
authors.lastname: Zwolska
authors.forename: Ewa
authors.initials: E
authors.lastname: Augustynowicz-Kopeć
mesh_terms: D000328:Adult; D000368:Aged; D054908:Extensively Drug-Resistant Tuberculosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011044:Poland / Q000453:epidemiology; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology