title: [Resistance to first-line drugs and major genotypic lineages of Mycobacterium tuberculosis in the 3 French Department of the Americas: Profiles, evolution, and trends (1995-2011)].
abstract: This is the first overview on resistant and multidrug resistant isolates of Mycobacterium tuberculosis circulating in the French Department of the Americas (Guadeloupe, Martinique, and French Guiana) over 17 years (January 1995-December 2011). A total of 1,239 cases were studied: 1,199 new cases (primary and multidrug resistance of 11.8 and 1.6% respectively), and 40 persistent (defined as cases with a previous history of positive culture over 6 months interval and whose spoligotypes remain unchanged), in which significantly higher proportions of resistance to at least isoniazid (22.5%, P = 0.002), rifampicin (20.0%, P < 0.001), and multidrug resistance (17.5%, P < 0.001) were observed as compared to new cases. The 281 spoligotypes obtained showed the presence of five major lineages, T (29.9%), LAM (23.9%), Haarlem (22.1%), EAI (7.1%), and X (6.7%). Two of these lineages, X and LAM, predominate among resistant and multidrug resistant isolates respectively (X: 10.5% of resistant isolates, P = 0.04; LAM: 42.3% of multidrug resistant isolates, P = 0.02). Four of the 19 major spoligo-profiles, corresponding to SIT 20, 64, 45, and 46, were significantly associated with drug resistance. Among them, genotype SIT 20, associated with monoresistance to isoniazid and multidrug resistance, would be actively and persistently in circulation, since 1999, in French Guiana, department in which one may also observe the presence of strains of M. tuberculosis phylogeographically associated to Guiana and Suriname (SIT 131 and SIT 1340).
authors.affiliation: WHO Supranational TB Reference Laboratory, unité de la tuberculose et des mycobactéries, institut Pasteur de Guadeloupe, Morne Jolivière, BP 484, F-97183, Abymes Cedex, Guadeloupe.
authors.forename: J
authors.initials: J
authors.lastname: Millet
authors.forename: M
authors.initials: M
authors.lastname: Berchel
authors.forename: F
authors.initials: F
authors.lastname: Prudenté
authors.forename: E
authors.initials: E
authors.lastname: Streit
authors.forename: A-G
authors.initials: AG
authors.lastname: Bomer
authors.forename: F
authors.initials: F
authors.lastname: Schuster
authors.forename: J
authors.initials: J
authors.lastname: Vanhomwegen
authors.forename: D
authors.initials: D
authors.lastname: Paasch
authors.forename: I
authors.initials: I
authors.lastname: Galbert
authors.forename: E
authors.initials: E
authors.lastname: Valery
authors.forename: R
authors.initials: R
authors.lastname: Aga
authors.forename: N
authors.initials: N
authors.lastname: Rastogi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology*; D015373:Bacterial Typing Techniques / Q000379:methods; D002648:Child; D015897:Comorbidity; D004269:DNA, Bacterial / Q000235:genetics; D021901:DNA, Intergenic / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D005260:Female; D005616:French Guiana / Q000453:epidemiology; D005798:Genes, Bacterial; D005838:Genotype; D019430:Guadeloupe / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008395:Martinique / Q000453:epidemiology; D008875:Middle Aged; D018598:Minisatellite Repeats; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D010802:Phylogeny; D012091:Repetitive Sequences, Nucleic Acid; D012189:Retrospective Studies; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial; D021901:DNA, Intergenic