Gert van der Hoek
In Memoriam - Editor, Senior Moderator
Clin Microbiol Infect. 2010 Aug 20.
Tuberculosis Drug-Resistance in Lisbon, Portugal: a Six-Year Overview.
ABSTRACT Multidrug-resistance and extensive drug-resistance pose a serious threat to tuberculosis management in Portugal. The country has high TB incidence rates in comparison with the other European Union countries, with Lisbon Health Region being one of the most affected regions.
In the present study we have analyzed a convenience sample of 3 025 Mycobacterium tuberculosis clinical isolates, recovered over a six-year period (2001-2006) in Lisbon Health Region, regarding drug-resistance both to first-line and second-line drugs.
Moreover, one hundred of these isolates were also genotyped by 12-loci Mycobacterial Interspersed Repetitive Unit - Variable Number of Tandem Repeats (MIRU-VNTR) analysis.
We have compared each year and observed the existence of 22 different resistance profiles with MDR-TB rates ranging between 9.9-15.2% and XDR-TB rates, relative to the number of MDR-TB isolates, between 44.3-66.1% (excluding one year here considered as an outlier).
A steady increase in the fraction of MDR-TB isolates resistant to all first-line drugs was also noticed. The genotyping analysis of MDR-TB isolates revealed six clusters, of which three (Lisboa3, Lisboa 4 and Q1) were related with XDR-TB.
Our results show that active transmission of MDR- and XDR-TB is taking place and that the high prevalence of observed XDR-TB is due to the continued transmission of particular genetic clusters.
An early detection of resistant cases would greatly benefit from the enforcement in case detection and implementation of genotyping in diagnostic routines.
http://www.ncbi.nlm.nih.gov/pubmed/20731680
Tuberculosis Drug-Resistance in Lisbon, Portugal: a Six-Year Overview.
ABSTRACT Multidrug-resistance and extensive drug-resistance pose a serious threat to tuberculosis management in Portugal. The country has high TB incidence rates in comparison with the other European Union countries, with Lisbon Health Region being one of the most affected regions.
In the present study we have analyzed a convenience sample of 3 025 Mycobacterium tuberculosis clinical isolates, recovered over a six-year period (2001-2006) in Lisbon Health Region, regarding drug-resistance both to first-line and second-line drugs.
Moreover, one hundred of these isolates were also genotyped by 12-loci Mycobacterial Interspersed Repetitive Unit - Variable Number of Tandem Repeats (MIRU-VNTR) analysis.
We have compared each year and observed the existence of 22 different resistance profiles with MDR-TB rates ranging between 9.9-15.2% and XDR-TB rates, relative to the number of MDR-TB isolates, between 44.3-66.1% (excluding one year here considered as an outlier).
A steady increase in the fraction of MDR-TB isolates resistant to all first-line drugs was also noticed. The genotyping analysis of MDR-TB isolates revealed six clusters, of which three (Lisboa3, Lisboa 4 and Q1) were related with XDR-TB.
Our results show that active transmission of MDR- and XDR-TB is taking place and that the high prevalence of observed XDR-TB is due to the continued transmission of particular genetic clusters.
An early detection of resistant cases would greatly benefit from the enforcement in case detection and implementation of genotyping in diagnostic routines.
http://www.ncbi.nlm.nih.gov/pubmed/20731680