Insight into multidrug-resistant Beijing genotype Mycobacterium tuberculosis isolates in Myanmar. (November 2018)

• Record Type: Journal Article
• Authors: San, Lai Lai; Aye, Khin Saw; Oo, Nan Aye Thida; Shwe, Mu Mu; Fukushima, Yukari; Gordon, Stephen V.; Suzuki, Yasuhiko; Nakajima, Chie
• Is Part Of: International journal of infectious diseases. Volume 76(2018)
• Page Start: 109
• Page End: 119
• Publication Date: 2018-11
• Subjects: Mycobacterium tuberculosis -- Multidrug-resistant TB -- Beijing genotype -- MIRU-VNTR -- Myanmar; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2018.06.009
• Languages: English
• ISSNs: 1201-9712

Abstract

Abstract: Objectives: Myanmar is a World Health Organization high tuberculosis (TB) burden country with a high multidrug-resistant (MDR)-TB burden. Of significance, a high prevalence of the Beijing genotype of Mycobacterium tuberculosis (MTB) among MDR-MTB has been reported previously. A detailed genetic characterization of TB clinical isolates was performed in order to explore whether there is an association between the prevalence of the Beijing MTB genotype and MDR-TB in Myanmar. Methods: A total of 265 MDR-MTB clinical isolates collected in 2010 and 2012 were subjected to spoligotyping, mycobacterial interspersed repetitive unit–variable number tandem repeat (MIRU-VNTR) analysis, single nucleotide polymorphism (SNP) typing, and drug resistance-associated gene sequencing, including rpoC to detect potential compensatory evolution. Results: Of the total MDR-MTB isolates, 79.2% (210/265) were of the Beijing genotype, the majority of which were the 'modern' subtype. Beijing genotype isolates were differentiated by 15-locus MIRU-VNTR and a high clustering rate (53.0%) was observed in the modern subtype. These MIRU-VNTR patterns were similar to Beijing genotype clones spreading across Russia and Central Asia. A high prevalence of katG Ser315Thr, and genetic evidence of extensive drug resistance (XDR) and pre-XDR and compensatory mutations in rpoC were observed among clustered isolates. Conclusions: MDR-MTB strains of the Beijing genotype might be spreading in Myanmar and present a major challenge to TB control in this country.