title: Distribution and association of Mycobacterium tuberculosis CAS lineage with multidrug resistance in North India.
abstract: A tertiary care hospital in North India.
  
  
  
  To determine the prevalence of different genotypes and examine their association with drug resistance among clinical isolates of Mycobacterium tuberculosis from the northern region of India.
  
  
  
  We analysed 100 clinical isolates of M. tuberculosis using mycobacterial interspersed repetitive units genotyping and TbD1 analysis.
  
  
  
  The analysis revealed that 34% of strains belonged to the Delhi/CAS (TbD1-) lineage, 32% had unknown patterns (27 TbD1-, 5 TbD1+), 18% were of Beijing genotype (TbD1-) and 11% were of EAI lineages (TbD1+). Twenty-one strains were multidrug-resistant tuberculosis (MDR-TB), 9 of which belonged to the Delhi/CAS lineage, 4 were of Beijing lineage, 6 were of unknown pattern and one was of EAI lineage. Our meta-analysis showed the overall proportion of CAS lineage to be 42.96% (95%CI 33-52); the CAS lineage had no association with MDR-TB (OR 0.89, 95%CI 0.66-1.20).
  
  
  
  The study highlights the high proportion of CAS lineage strains and absence of association with MDR-TB. The distribution and identification of different genotypes of M. tuberculosis could help in better understanding the factors that influence disease transmission and drug resistance.
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Dhatwalia
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: R
authors.initials: R
authors.lastname: Yadav
authors.affiliation: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: D
authors.initials: D
authors.lastname: Behera
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: S M
authors.initials: SM
authors.lastname: Rudramurthy
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: H
authors.initials: H
authors.lastname: Kaur
authors.affiliation: Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Sethi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D056426:Genetic Loci; D060005:Genotyping Techniques; D006801:Humans; D007194:India / Q000453:epidemiology; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D012293:Rifampin / Q000627:therapeutic use; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial; D007538:Isoniazid; D012293:Rifampin