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dc.contributor.authorPardini, M
dc.contributor.authorNiemann, S
dc.contributor.authorVaraine, F
dc.contributor.authorIona, E
dc.contributor.authorMeacci, F
dc.contributor.authorOrrù, G
dc.contributor.authorYesilkaya, H
dc.contributor.authorJarosz, T
dc.contributor.authorAndrew, P
dc.contributor.authorBarer, M
dc.contributor.authorChecchi, F
dc.contributor.authorRinder, H
dc.contributor.authorOrefici, G
dc.contributor.authorRüsch-Gerdes, S
dc.contributor.authorFattorini, L
dc.contributor.authorOggioni, M R
dc.contributor.authorBonnet, M
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.
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.journalTuberculosisen
refterms.dateFOA2019-03-04T08:46:27Z
html.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.


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