title: Multidrug-resistant Myobacterium tuberculosis caused by the Beijing genotype and a specific T1 genotype clone (SIT No. 266) is widely transmitted in Minsk.
abstract: METHODS
  This study was performed in the city of Minsk in Belarus, where a very severe problem with MDR-TB was demonstrated in a recent drug resistant survey.
  
  
  OBJECTIVE
  The aim of this study was to use molecular typing of MDR and pan-susceptible clinical isolates of Mycobacterium tuberculosis to increase the understanding of the transmission patterns and possible differences between the strains causing susceptible and drug-resistant tuberculosis.
  
  
  METHODS
  Consecutive isolates from pulmonary TB patients in Minsk were collected at the Belarusian National Reference Laboratory. Isolates found to be either pan-susceptible or MDR were included in the study, which totally comprised 81 MDR and 82 pan-susceptible clinical isolates. All isolates were characterized by spoligotyping. The major clusters were characterized using sequencing of the pncA gene.
  
  
  RESULTS
  Three out of four MDR cases were caused by one out of two drug-resistant clones of M. tuberculosis belonging to the Beijing and T1 genotypes, respectively. A single T1 clone, SIT No. 266, found exclusively in the MDR cohort, was shown to cause no less than 30% of all MDR-TB cases.
  
  
  CONCLUSIONS
  The findings indicate that the major cause of MDR-TB in Minsk is an ongoing transmission of certain already resistant M. tuberculosis strains.
  
  
  CONCLUSIONS
  The significant transmission of MDR-TB in Minsk underlines the urgent need for strengthened infection control measures to limit the transmission in order to better control MDR-TB.
authors.affiliation: Republican Scientific and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.
authors.forename: Aksana
authors.initials: A
authors.lastname: Zalutskaya
authors.affiliation: Swedish Institute for Communicable Disease Control, Solna, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Wijkander
authors.affiliation: Swedish Institute for Communicable Disease Control, Solna, Sweden.
authors.forename: Pontus
authors.initials: P
authors.lastname: Jureen
authors.affiliation: Republican Scientific and Practical Centre for Pulmonology and Tuberculosis, Minsk, Belarus.
authors.forename: Alena
authors.initials: A
authors.lastname: Skrahina
authors.affiliation: Swedish Institute for Communicable Disease Control, Solna, Sweden. Electronic address: sven.hoffner@smi.se.
authors.forename: Sven
authors.initials: S
authors.lastname: Hoffner
keywords: MDR-TB; Molecular epidemiology; Spoligotyping; pncA Gene