Genetic diversity of Mycobacterium tuberculosis in Madang, Papua New Guinea.
METHODS
Madang and surroundings, Papua New Guinea (PNG).


OBJECTIVE
To characterise the genetic diversity and drug susceptibility of Mycobacterium tuberculosis isolates collected in Madang and surroundings.


METHODS
M. tuberculosis was isolated from sputum samples  from active pulmonary tuberculosis cases. Drug resistance profiles were obtained by drug susceptibility testing. M. tuberculosis lineages were identified by single nucleotide polymorphisms and sub-typing was performed by spoligotyping. Spoligotyping and 24 locus mycobacterial interspersed  repetitive units-variable number of tandem repeats were combined to identify clustered isolates.


RESULTS
The 173 M. tuberculosis isolates collected belonged predominantly to the Euro-American lineage (Lineage 4) and the East-Asian lineage (Lineage 2). Multidrug-resistant M. tuberculosis  were observed in 5.2% of isolates. Lineage 2 M. tuberculosis, which includes the 'Beijing' genotype, was significantly associated with any drug resistance (OR 5.2, 95%CI 1.8-15.1). Cluster analyses showed 44% molecularly clustered isolates, suggesting transmission  of M. tuberculosis in the community, including transmission of primary drug-resistant M. tuberculosis.


CONCLUSIONS
These data provide the first insight into the molecular characteristics of M. tuberculosis in the Madang area of PNG, and indicate substantial drug resistance  with evidence of ongoing transmission.
Swiss Tropical and Public Health Institute, Basel, Switzerland.
M
M
Ballif
P
P
Harino
S
S
Ley
R
R
Carter
C
C
Coulter
S
S
Niemann
S
S
Borrell
L
L
Fenner
P
P
Siba
S
S
Phuanukoonnon
S
S
Gagneux
H-P
HP
Beck
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D016015:Logistic Models; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018598:Minisatellite Repeats; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D016017:Odds Ratio; D010219:Papua New Guinea / Q000453:epidemiology; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D018570:Risk Assessment; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D055815:Young Adult
D000995:Antitubercular Agents