title: Dominant incidence of multidrug and extensively drug-resistant specific Mycobacterium tuberculosis clones in Osaka Prefecture, Japan.
abstract: Infection and transmission of multidrug-resistant Mycobacterium tuberculosis (MDR-Mtb) and extensively drug-resistant M. tuberculosis (XDR-Mtb) is a serious health problem. We analyzed a total of 1,110 Mtb isolates in Osaka Prefecture and neighboring areas from April 2000 to March 2009. A total of 89 MDR-Mtb were identified, 36 (48.5%) of which were determined to be XDR-Mtb. Among the 89 MDR-Mtb isolates, 24 (27.0%) phylogenetically distributed into six clusters based on mycobacterial interspersed repetitive units-various number of tandem repeats (MIRU-VNTR) typing. Among these six clusters, the MIRU-VNTR patterns of four (OM-V02, OM-V03, OM-V04, and OM-V06) were only found for MDR-Mtb. Further analysis revealed that all isolates belonging to OM-V02 and OM-V03, and two isolates from OM-V04 were clonal. Importantly such genotypes were not observed for drug-sensitive isolates. These suggest that few but transmissible clones can transmit after acquiring multidrug resistance and colonize even in a country with a developed, well-organized healthcare system.
authors.affiliation: Department of Infectious Diseases, Osaka Prefectural Institute of Public Health, Osaka, Osaka, Japan. tamaru@iph.pref.osaka.jp
authors.forename: Aki
authors.initials: A
authors.lastname: Tamaru
authors.forename: Chie
authors.initials: C
authors.lastname: Nakajima
authors.forename: Takayuki
authors.initials: T
authors.lastname: Wada
authors.forename: Yajun
authors.initials: Y
authors.lastname: Wang
authors.forename: Manabu
authors.initials: M
authors.lastname: Inoue
authors.forename: Ryuji
authors.initials: R
authors.lastname: Kawahara
authors.forename: Ryoji
authors.initials: R
authors.lastname: Maekura
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Ozeki
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ogura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Sohkichi
authors.initials: S
authors.lastname: Matsumoto
mesh_terms: D016000:Cluster Analysis; D054908:Extensively Drug-Resistant Tuberculosis / Q000453:epidemiology* / Q000235:genetics* / Q000382:microbiology; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D015994:Incidence; D007564:Japan; D008826:Microbial Sensitivity Tests; D008957:Models, Genetic; D009154:Mutation; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000378:metabolism; D010802:Phylogeny; D011634:Public Health; D012091:Repetitive Sequences, Nucleic Acid; D017422:Sequence Analysis, DNA; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000235:genetics* / Q000382:microbiology