title: HIV infection and geographically bound transmission of drug-resistant tuberculosis, Argentina.
abstract: During 2003-2009, the National Tuberculosis (TB) Laboratory Network in Argentina gave 830 patients a new diagnosis of multidrug-resistant (MDR) TB and 53 a diagnosis of extensively drug- resistant (XDR) TB. HIV co-infection was involved in nearly one third of these cases. Strain genotyping showed that 7 major clusters gathered 56% of patients within restricted geographic areas. The 3 largest clusters corresponded to epidemic MDR TB strains that have been undergoing transmission for >10 years. The indigenous M strain accounted for 29% and 40% of MDR and XDR TB cases, respectively. Drug-resistant TB trends in Argentina are driven by spread of a few strains in hotspots where the rate of HIV infection is high. To curb transmission, the national TB program is focusing stringent interventions in these areas by strengthening infection control in large hospitals and prisons, expediting drug resistance detection, and streamlining information-sharing systems between HIV and TB programs.
authors.affiliation: Instituto Nacional de Enfermedades Infecciosas ANLIS Dr. Carlos G. Malbrán Buenos Aires, Argentina. vritacco@anlis.gov.ar
authors.forename: Viviana
authors.initials: V
authors.lastname: Ritacco
authors.forename: Beatriz
authors.initials: B
authors.lastname: López
authors.forename: Marta
authors.initials: M
authors.lastname: Ambroggi
authors.forename: Domingo
authors.initials: D
authors.lastname: Palmero
authors.forename: Bernardo
authors.initials: B
authors.lastname: Salvadores
authors.forename: Elida
authors.initials: E
authors.lastname: Gravina
authors.forename: Eduardo
authors.initials: E
authors.lastname: Mazzeo
authors.forename: Susana
authors.initials: S
authors.lastname: Imaz
authors.forename: Lucía
authors.initials: L
authors.lastname: Barrera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001118:Argentina / Q000453:epidemiology; D002648:Child; D016000:Cluster Analysis; D060085:Coinfection / Q000453:epidemiology*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology* / Q000635:transmission*; D055815:Young Adult