Association between genotype and drug resistance profiles of Mycobacterium tuberculosis strains circulating in China in a national drug resistance survey.
We describe the population structure of a representative collection of 3,133 Mycobacterium tuberculosis isolates, collected within the framework of a national resistance survey from 2007 in China. Genotyping data indicate that the epidemic strains in China can be divided into seven major complexes, of which 92% belonged to the East Asian (mainly Beijing strains) or the Euro-American lineage. The epidemic Beijing strains in China are closely related to the Beijing B0/W148 strain earlier described in Russia and a large cluster of these strains has spread national wide. The density of Beijing strains is high in the whole of China (average 70%), but the highest prevalence was found North of the Yellow river. The Euro-American lineage consists of three sublineages (sublineage_1, 2, and 3) and is more prevalent in the South. Beijing lineage showed the highest cluster rate of 48% and a significantly higher level of resistance to rifampicin (14%, p<0.001), ethambutol (9%, p = 0.001), and ofloxacin (5%, p = 0.011). Within the Euro-American Lineage, sublineage_3 revealed the highest cluster rate (28%) and presented a significantly elevated level of resistance to streptomycin (44%, p<0.001). Our findings suggest that standardised treatment in this region may have contributed to the successful spread of certain strains: sublineage_3 in the Euro-American lineage may have thrived when streptomycin was used without rifampicin for treatment, while later under DOTS based treatment, in which rifampicin plays a key role, Beijing lineage appears to be spreading.
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Yang
Y
Zhou
KNCV Tuberculosis Foundation, CC The Hague, The Netherlands.|Department of Global Health, Amsterdam Medical Center, Pietersbergweg 17, BM Amsterdam, The Netherlands.
Susan
S
van den Hof
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Shengfen
S
Wang
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Yu
Y
Pang
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Bing
B
Zhao
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Hui
H
Xia
National Institute for Public Health and the Environment, the Netherlands,BA Bilthoven, The Netherlands.
Richard
R
Anthony
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Xichao
X
Ou
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Qiang
Q
Li
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Yang
Y
Zheng
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Yuanyuan
Y
Song
Chinese Centre for Disease Control and Prevention, Changping district, Beijing, China, P.R.
Yanlin
Y
Zhao
National Institute for Public Health and the Environment, the Netherlands,BA Bilthoven, The Netherlands.
Dick
D
van Soolingen
D000995:Antitubercular Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D008826:Microbial Sensitivity Tests; D018598:Minisatellite Repeats / Q000235:genetics; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000235:genetics*; D012293:Rifampin / Q000627:therapeutic use; D013307:Streptomycin / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000235:genetics*
D000995:Antitubercular Agents; D012293:Rifampin; D013307:Streptomycin