NDLI: Transmission of multi-drug resistant tuberculosis in Mongolia is driven by Beijing strains of Mycobacterium tuberculosis resistant to all first-line drugs.

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Transmission of multi-drug resistant tuberculosis in Mongolia is driven by Beijing strains of Mycobacterium tuberculosis resistant to all first-line drugs.

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Transmission of multi-drug resistant tuberculosis in Mongolia is driven by Beijing strains of Mycobacterium tuberculosis resistant to all first-line drugs.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Gurjav, Ulziijargal Erkhembayar, Baasansuren Burneebaatar, Buyankhishig Narmandakh, Erdenegerel Tumenbayar, Oyuntuya Hill-Cawthorne, Grant A. Marais, Ben J. Sintchenko, Vitali
Description	Author Affiliation: Gurjav U ( Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia); Erkhembayar B ( National Tuberculosis Reference Laboratory, National Center for Communicable Diseases, Ulaanbaatar, Mongolia.); Burneebaatar B ( National Tuberculosis Reference Laboratory, National Center for Communicable Diseases, Ulaanbaatar, Mongolia.); Narmandakh E ( National Tuberculosis Reference Laboratory, National Center for Communicable Diseases, Ulaanbaatar, Mongolia.); Tumenbayar O ( National Tuberculosis Reference Laboratory, National Center for Communicable Diseases, Ulaanbaatar, Mongolia.); Hill-Cawthorne GA ( Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia); Marais BJ ( Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia.); Sintchenko V ( Sydney Medical School, Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia)
Abstract	BACKGROUND: Mongolia has high and rising rates of multi-drug resistant tuberculosis (MDR-TB). Spatio-temporal and programmatic evidence suggests a major contribution from MDR-TB transmission, but genotypic evidence has not been assessed. METHODS: All MDR-TB cases identified during 2012 were examined. Demographic and bacteriological data were obtained from the National Tuberculosis Reference Laboratory. Isolates of Mycobacterium tuberculosis from culture-confirmed category 1 treatment failures were genotyped using 24-loci mycobacterium interspersed repetitive unit (MIRU-24) analysis. RESULTS: Of the 210 MDR-TB cases identified, 115 (54.8%) were treatment failures (34.8% category 1; 20.0% category 2). Streptomycin resistance was present in 156 (74.3%) cases; including 55/73 (75.3%) category 1 treatment failures who had never been exposed to streptomycin. Among category 1 treatment failures, Beijing lineage strains predominated (88.0%; 59/67 of genotyped isolates). MIRU-24 clustering was documented in 62.7% (42/67) of strains; 55.2% (37/67) remained clustered when drug susceptibility test results were considered. In total 59.5% (25/42) of clustered strains were Beijing lineage and demonstrated in-vitro resistance to all first-line drugs tested. CONCLUSION: The MDR-TB epidemic in Mongolia appears to be driven by primary transmission of Beijing lineage strains resistant to all first-line drugs. Enhanced infection control strategies together with early MDR-TB case detection and appropriate treatment are necessary to limit escalation of the MDR-TB epidemic.
File Format	HTM / HTML
ISSN	14729792
Journal	Tuberculosis
Volume Number	101
e-ISSN	1873281X
Language	English
Publisher	Elsevier
Publisher Date	2016-12-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pulmonary Medicine
Content Type	Text
Resource Type	Article
Subject	Infectious Diseases Immunology Microbiology Microbiology (medical)

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