title: Transmission of extensively drug-resistant and multidrug resistant Mycobacterium tuberculosis in families identified by genotyping.
abstract: BACKGROUND
  Diagnosis and appropriate treatment of multidrug-resistant tuberculosis (MDR-TB) remain major challenges. We sought to elucidate that persons who share a household with drug resistance tuberculosis patients are at high risk for primary drug resistance tuberculosis and how to prevent these outbreaks.
  
  
  METHODS
  We used 12-locus mycobacterial interspersed repetitive unit and 7-locus variable-number tandem repeat to identify household transmission of extensively drug resistant and multiple drug resistant Mycobacterium tuberculosis in three families admitted in Shanghai Pulmonary Hospital affiliated with Tongji University. Drug susceptibility tests were done by the modified proportion method in the MGIT 960 system in the same time. Clinical data were also obtained from the subjects' medical records.
  
  
  RESULTS
  All of the six strains were defined as Beijing genotype by the deletion-targeted multiplex PCR (DTM-PCR) identification on the genomic deletion RD105. Strains from family-1 had the same minisatellite interspersed repetitive unit (MIRU) pattern (232225172531) and the same MIRU pattern (3677235). Strains from family-2 had the same MIRU pattern (2212261553323) and the same MIRU pattern (3685134). Strains from family-3 did not have the same MIRU pattern and they differed at only one locus (223326173533, 223325173533), and did not have the same VNTR pattern with two locus differed (3667233, 3677234).
  
  
  CONCLUSIONS
  Household transmission exists in the three families. A clear chain of tuberculosis transmission within family exists. Tuberculosis susceptibility should be considered when there is more than one tuberculosis patients in a family. Household tuberculosis transmission could be prevented with adequate treatment of source patients.
authors: Key Laboratory of Mycobacteria Tuberculosis, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China.
authors: Li-ping
authors: LP
authors: Yan
authors: Lian-hua
authors: LH
authors: Qin
authors: Qing
authors: Q
authors: Zhang
authors: Hua
authors: H
authors: Sun
authors: Min
authors: M
authors: Han
authors: He-ping
authors: HP
authors: Xiao
mesh_terms: D000328:Adult; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D060885:Multiplex Polymerase Chain Reaction; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity; D011859:Radiography; D018088:Tuberculosis, Multidrug-Resistant / Q000000981:diagnostic imaging / Q000635:transmission*; D055815:Young Adult