title: Molecular epidemiology of tuberculosis in Kaohsiung City located at southern Taiwan, 2000-2008.
abstract: BACKGROUND
  We present the first comprehensive analysis of Mycobacterium tuberculosis (MTB) isolates circulating in southern Taiwan. In this 9-year population-based study, the TB situation in the Kaohsiung region was characterized by genotypic analysis of 421 MTB isolates.
  
  
  METHODS
  All 421 isolates of MTB were analyzed by spoligotyping and MIRU-VNTR typing. Drug-resistance patterns were also analyzed.
  
  
  RESULTS
  The percentage of EAI (East African-Indian) strains increased across sampling years (2000-2008) in southern Taiwan, whereas the proportion of Beijing lineages remained unchanged. Clustering was more frequent with EAI genotype infections (odds ratio = 3.6, p<0.0001) when compared to Beijing genotypes. Notably, MTB resistance to streptomycin (STR) had significantly increased over time, but resistance to other antibiotics, including multidrug resistance, had not. Three major genes (gidB, rpsL and rrs) implicated in STR resistance were sequenced and specific mutations identified.
  
  
  CONCLUSIONS
  This study revealed that EAI strains were highly transmissible and that STR resistance has increased between 2000 and 2008 in Kaohsiung, Taiwan.
authors: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan; Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiaya City, Taiwan.
authors: Yih-Yuan
authors: YY
authors: Chen
authors: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan.
authors: Jia-Ru
authors: JR
authors: Chang
authors: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan.
authors: Shu-Chen
authors: SC
authors: Kuo
authors: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan; Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan.
authors: Fan-Chen
authors: FC
authors: Tseng
authors: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan.
authors: Wei-Chen
authors: WC
authors: Huang
authors: Department of Microbiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Tsi-Shu
authors: TS
authors: Huang
authors: Department of Microbiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors: Yao-Shen
authors: YS
authors: Chen
authors: Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors: Tzong-Shi
authors: TS
authors: Chiueh
authors: Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
authors: Jun-Ren
authors: JR
authors: Sun
authors: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan.
authors: Ih-Jen
authors: IJ
authors: Su
authors: National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan.
authors: Horng-Yunn
authors: HY
authors: Dou
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D024881:Drug Resistance, Bacterial / Q000235:genetics; D016680:Genome, Bacterial; D006801:Humans; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000302:isolation & purification*; D020641:Polymorphism, Single Nucleotide; D012189:Retrospective Studies; D013307:Streptomycin / Q000627:therapeutic use; D013624:Taiwan / Q000453:epidemiology; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D013307:Streptomycin
references: Mol Microbiol. 2007 Feb;63(4):1096-106
references: 17238915
references: J Clin Microbiol. 2006 Dec;44(12):4498-510
references: 17005759
references: Clin Microbiol Infect. 2009 Jan;15 Suppl 1:66-8
references: 19220360
references: FEMS Immunol Med Microbiol. 2010 Feb;58(1):119-27
references: 19889037
references: PLoS One. 2010;5(4):e10191
references: 20419138
references: J Antimicrob Chemother. 2010 Nov;65(11):2341-6
references: 20802233
references: Antimicrob Agents Chemother. 2011 May;55(5):2032-41
references: 21300839
references: Antimicrob Agents Chemother. 2011 Jun;55(6):2515-22
references: 21444711
references: J Clin Microbiol. 2011 Jul;49(7):2625-30
references: 21593257
references: BMC Evol Biol. 2011;11:247
references: 21878130
references: PLoS One. 2011;6(9):e23870
references: 21931620
references: Infect Genet Evol. 2012 Jan;12(1):28-37
references: 22036788
references: Nat Commun. 2012;3:753
references: 22434196
references: Infect Genet Evol. 2012 Jun;12(4):755-66
references: 22365971
references: Int J Tuberc Lung Dis. 2012 Apr;16(4):527-31
references: 22640514
references: PLoS One. 2012;7(7):e39792
references: 22808061
references: BMC Microbiol. 2012;12:90
references: 22646308
references: PLoS One. 2012;7(8):e43018
references: 22937008
references: Trends Microbiol. 2002 Jan;10(1):45-52
references: 11755085
references: Mol Microbiol. 2000 May;36(3):762-71
references: 10844663
references: PLoS Pathog. 2013 Aug;9(8):e1003543
references: 23966858
references: J Clin Microbiol. 1992 Oct;30(10):2567-75
references: 1400955
references: Infect Immun. 1993 Oct;61(10):4173-81
references: 8406806
references: Genome Res. 2005 Oct;15(10):1357-64
references: 16169923
references: Proc Natl Acad Sci U S A. 2006 Feb 21;103(8):2869-73
references: 16477032
references: BMC Microbiol. 2006;6:23
references: 16519816
references: BMC Infect Dis. 2008;8:170
references: 19102768