title: Molecular strain typing of Mycobacterium tuberculosis complex in Bamako, Mali.
abstract: OBJECTIVE
  To identify strains of Mycobacterium tuberculosis complex (MTC) circulating in Bamako and to examine the relationship between the strains and their drug susceptibility profiles.
  
  
  METHODS
  Between 2006 and 2010, we conducted a cross-sectional study using spoligotyping to identify strains of MTC recovered from 126 tuberculosis (TB) patients under treatment in Bamako, Mali.
  
  
  RESULTS
  Three members of the MTC were isolated: M. tuberculosis (71.4%), M. africanum (27.8%) and M. bovis (0.8%). Of these, three strains were found to be the most prevalent: M. tuberculosis T1 (MTB T1; 38.9%), M. africanum F2 (MAF2; 26.2%) and M. tuberculosis Latin American and Mediterranean 10 (MTB LAM 10; 10.3%). MAF2 and MTB LAM 10 strains have a lower risk of multidrug resistance (MDR) than MTB T1 (respectively OR 0.1, 95%CI 0.03-0.4 and OR 0.1, 95%CI 0.01-0.8). Age ≥ 32 years (OR 1.4, 95%CI 0.4-3.9), negative human immunodeficiency virus status (OR 0.4, 95%CI 0.1-2.5) and male sex (OR 4, 95%CI 0.9-16.5) were not associated with MDR. The prevalence of MDR among treatment and retreatment failure patients was respectively 25% and 81.8% compared to new patients (2.9%).
  
  
  CONCLUSIONS
  This study indicates a low level of primary drug resistance in Bamako, affirms the importance of using correct drug regimens, and suggests that the MTB T1 strain may be associated with the development of resistance.
authors.affiliation: Project SEREFO-NIAID (Centre de Recherche et de Formation sur VIH/Sida et Tuberculose-Institut National des Maladies Infectieuses et Allergiques)/University of Bamako Research Collaboration on HIV-TB, Bamako, Mali.
authors.forename: B
authors.initials: B
authors.lastname: Traore
authors.forename: B
authors.initials: B
authors.lastname: Diarra
authors.forename: B P P
authors.initials: BP
authors.lastname: Dembele
authors.forename: A M
authors.initials: AM
authors.lastname: Somboro
authors.forename: A S
authors.initials: AS
authors.lastname: Hammond
authors.forename: S
authors.initials: S
authors.lastname: Siddiqui
authors.forename: M
authors.initials: M
authors.lastname: Maiga
authors.forename: B
authors.initials: B
authors.lastname: Kone
authors.forename: Y S
authors.initials: YS
authors.lastname: Sarro
authors.forename: J
authors.initials: J
authors.lastname: Washington
authors.forename: M
authors.initials: M
authors.lastname: Parta
authors.forename: N
authors.initials: N
authors.lastname: Coulibaly
authors.forename: O
authors.initials: O
authors.lastname: M'baye
authors.forename: S
authors.initials: S
authors.lastname: Diallo
authors.forename: O
authors.initials: O
authors.lastname: Koita
authors.forename: A
authors.initials: A
authors.lastname: Tounkara
authors.forename: M A
authors.initials: MA
authors.lastname: Polis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015373:Bacterial Typing Techniques; D003430:Cross-Sectional Studies; D005260:Female; D006678:HIV / Q000302:isolation & purification*; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D008297:Male; D008302:Mali; D008875:Middle Aged; D058889:Molecular Typing / Q000379:methods*; D009161:Mycobacterium / Q000302:isolation & purification; D009163:Mycobacterium bovis / Q000302:isolation & purification; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D012307:Risk Factors; D013183:Sputum; D014376:Tuberculosis / Q000382:microbiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents