Characteristics of drug-resistant tuberculosis in Abkhazia (Georgia), a high-prevalence area in Eastern Europe

Hdl Handle:
http://hdl.handle.net/10144/132810
Title:
Characteristics of drug-resistant tuberculosis in Abkhazia (Georgia), a high-prevalence area in Eastern Europe
Authors:
Pardini, Manuela; Niemann, Stefan; Varaine, Francis; Iona, Elisabetta; Meacci, Francesca; Orrù, Germano; Yesilkaya, Hasan; Jarosz, Thierry; Andrew, Peter; Barer, Mike; Checchi, Francesco; Rinder, Heinz; Orefici, Graziella; Rüsch-Gerdes, Sabine; Fattorini, Lanfranco; Oggioni, Marco Rinaldo; Bonnet, Maryline
Journal:
Tuberculosis (Edinburgh, Scotland)
Abstract:
Although multidrug-resistant (MDR) tuberculosis (TB) is a major public health problem in Eastern Europe, the factors contributing to emergence, spread and containment of MDR-TB are not well defined. Here, we analysed the characteristics of drug-resistant TB in a cross-sectional study in Abkhazia (Georgia) between 2003 and 2005, where standard short-course chemotherapy is supplemented with individualized drug-resistance therapy. Drug susceptibility testing (DST) and molecular typing were carried out for Mycobacterium tuberculosis complex strains from consecutive smear-positive TB patients. Out of 366 patients, 60.4% were resistant to any first-line drugs and 21% had MDR-TB. Overall, 25% of all strains belong to the Beijing genotype, which was found to be strongly associated with the risk of MDR-TB (OR 25.9, 95% CI 10.2-66.0) and transmission (OR 2.8, 95% CI 1.6-5.0). One dominant MDR Beijing clone represents 23% of all MDR-TB cases. The level of MDR-TB did not decline during the study period, coinciding with increasing levels of MDR Beijing strains among previously treated cases. Standard chemotherapy plus individualized drug-resistance therapy, guided by conventional DST, might be not sufficient to control MDR-TB in Eastern Europe in light of the spread of "highly transmissible" MDR Beijing strains circulating in the community.
Affiliation:
Dipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, Rome, Italy; Forschungszentrum Borstel National Reference Center for Mycobacteria, Borstel, Germany; Medecins Sans Frontieres, Paris, France; Dipartimento di Biologia Molecolare, Universita` di Siena, Italy; Dipartimento di Scienze Odontostomatologiche, Universita` di Cagliari, Italy; University of Leicester, United Kingdom; 3Es (Essai clinique Evaluation Epidemiologie Statistiques), Paris, France; London School of Hygiene and Tropical Medicine, London, United Kingdom; LGL, Oberschleibheim, Germany; Epicentre, Geneva, Switzerland
Issue Date:
18-Jun-2009
URI:
http://hdl.handle.net/10144/132810
DOI:
10.1016/j.tube.2009.04.002
PubMed ID:
19539531
Additional Links:
http://www.tuberculosisjournal.com/article/S1472-9792(09)00030-4/abstract
Submitted date:
2010-10-15
Type:
Article
Language:
en
ISSN:
1873-281X
Appears in Collections:
TB

Full metadata record

DC FieldValue Language
dc.contributor.authorPardini, Manuelaen
dc.contributor.authorNiemann, Stefanen
dc.contributor.authorVaraine, Francisen
dc.contributor.authorIona, Elisabettaen
dc.contributor.authorMeacci, Francescaen
dc.contributor.authorOrrù, Germanoen
dc.contributor.authorYesilkaya, Hasanen
dc.contributor.authorJarosz, Thierryen
dc.contributor.authorAndrew, Peteren
dc.contributor.authorBarer, Mikeen
dc.contributor.authorChecchi, Francescoen
dc.contributor.authorRinder, Heinzen
dc.contributor.authorOrefici, Graziellaen
dc.contributor.authorRüsch-Gerdes, Sabineen
dc.contributor.authorFattorini, Lanfrancoen
dc.contributor.authorOggioni, Marco Rinaldoen
dc.contributor.authorBonnet, Marylineen
dc.date.accessioned2011-06-08T23:43:39Z-
dc.date.available2011-06-08T23:43:39Z-
dc.date.issued2009-06-18-
dc.date.submitted2010-10-15-
dc.identifier.citationTuberculosis (Edinb)2009;89 (4):317-24en
dc.identifier.issn1873-281X-
dc.identifier.pmid19539531-
dc.identifier.doi10.1016/j.tube.2009.04.002-
dc.identifier.urihttp://hdl.handle.net/10144/132810-
dc.description.abstractAlthough multidrug-resistant (MDR) tuberculosis (TB) is a major public health problem in Eastern Europe, the factors contributing to emergence, spread and containment of MDR-TB are not well defined. Here, we analysed the characteristics of drug-resistant TB in a cross-sectional study in Abkhazia (Georgia) between 2003 and 2005, where standard short-course chemotherapy is supplemented with individualized drug-resistance therapy. Drug susceptibility testing (DST) and molecular typing were carried out for Mycobacterium tuberculosis complex strains from consecutive smear-positive TB patients. Out of 366 patients, 60.4% were resistant to any first-line drugs and 21% had MDR-TB. Overall, 25% of all strains belong to the Beijing genotype, which was found to be strongly associated with the risk of MDR-TB (OR 25.9, 95% CI 10.2-66.0) and transmission (OR 2.8, 95% CI 1.6-5.0). One dominant MDR Beijing clone represents 23% of all MDR-TB cases. The level of MDR-TB did not decline during the study period, coinciding with increasing levels of MDR Beijing strains among previously treated cases. Standard chemotherapy plus individualized drug-resistance therapy, guided by conventional DST, might be not sufficient to control MDR-TB in Eastern Europe in light of the spread of "highly transmissible" MDR Beijing strains circulating in the community.en
dc.language.isoenen
dc.relation.urlhttp://www.tuberculosisjournal.com/article/S1472-9792(09)00030-4/abstracten
dc.rightsArchived with thanks to Elsevier and Tuberculosis (Edinburgh, Scotland)en
dc.subject.meshTBen
dc.subject.meshEastern Europeen
dc.titleCharacteristics of drug-resistant tuberculosis in Abkhazia (Georgia), a high-prevalence area in Eastern Europeen
dc.typeArticleen
dc.contributor.departmentDipartimento di Malattie Infettive, Parassitarie e Immunomediate, Istituto Superiore di Sanità, Rome, Italy; Forschungszentrum Borstel National Reference Center for Mycobacteria, Borstel, Germany; Medecins Sans Frontieres, Paris, France; Dipartimento di Biologia Molecolare, Universita` di Siena, Italy; Dipartimento di Scienze Odontostomatologiche, Universita` di Cagliari, Italy; University of Leicester, United Kingdom; 3Es (Essai clinique Evaluation Epidemiologie Statistiques), Paris, France; London School of Hygiene and Tropical Medicine, London, United Kingdom; LGL, Oberschleibheim, Germany; Epicentre, Geneva, Switzerlanden
dc.identifier.journalTuberculosis (Edinburgh, Scotland)en

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