title: Multidrug-resistant tuberculosis in Port-au-Prince, Haiti.
abstract: OBJECTIVE
  To determine the prevalence of multidrug-resistant tuberculosis (MDR-TB) among patients with new smear-positive pulmonary TB in Port-au-Prince, Haiti.
  
  
  METHODS
  Sputum samples were cultured from 1 006 patients newly diagnosed with TB in 2008. The core region of the rpoB gene that is associated with resistance to rifampin was sequenced. All isolates with rpoB mutations were sent to the New York State reference laboratory for conventional drug susceptibility testing (DST). All isolates were also tested with the GenoType MTBDRplus line-probe assay.
  
  
  RESULTS
  Mycobacterium tuberculosis was isolated from 906 patients. Twenty-six (2.9%) of the isolates had missense mutations or deletions in rpoB and were resistant to rifampin by DST. All 26 were also resistant to isoniazid and classified as MDR-TB. Forty-six control isolates without rpoB mutations were found to be rifampin sensitive by DST. The GenoType MTBDRplus line-probe assay correctly identified 26 MDR-TB strains. It misclassified one pansusceptible isolate as rifampin resistant.
  
  
  CONCLUSIONS
  This study shows an MDR-TB prevalence of 2.9% in newly diagnosed TB patients in Haiti and suggests that rpoB sequencing and hybridization assays are good screening tools for early detection of MDR-TB.
authors.affiliation: Center for Global Health, Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, United States of America. oko2001@med.cornell.edu
authors.forename: Oksana
authors.initials: O
authors.lastname: Ocheretina
authors.forename: Willy
authors.initials: W
authors.lastname: Morose
authors.forename: Marie
authors.initials: M
authors.lastname: Gauthier
authors.forename: Patrice
authors.initials: P
authors.lastname: Joseph
authors.forename: Richard
authors.initials: R
authors.lastname: D'Meza
authors.forename: Vincent E
authors.initials: VE
authors.lastname: Escuyer
authors.forename: Nalin
authors.initials: N
authors.lastname: Rastogi
authors.forename: Guy
authors.initials: G
authors.lastname: Vernet
authors.forename: Jean W
authors.initials: JW
authors.lastname: Pape
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Fitzgerald
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000187:drug effects / Q000235:genetics; D002947:Cities / Q000453:epidemiology; D003430:Cross-Sectional Studies; D012321:DNA-Directed RNA Polymerases; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D007538:Isoniazid / Q000494:pharmacology; D008297:Male; D009169:Mycobacterium tuberculosis / Q000235:genetics; D015995:Prevalence; D012293:Rifampin / Q000494:pharmacology; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D001426:Bacterial Proteins; C505805:rpoB protein, Mycobacterium tuberculosis; D012321:DNA-Directed RNA Polymerases; D007538:Isoniazid; D012293:Rifampin