Abstract
Background: Tuberculosis (TB) is still a big threat to human health, especially in children. However, an isolation of Mycobacteriumtuberculosis culture frompediatric cases remainsachallenge. In order to provide some scientific basis for children TB control, we investigated the genotyping and drug resistance characteristics of M. tuberculosis isolates from pediatric cases in China. Methods&Materials: In this study, a total of 440 strains including 90 from children ( 18 years) isolated in 25 provinces across Chinawere subjected to spoligotyping and drug susceptibility testing. Results:As a result, Beijing family strainswere shown to remain predominant in China (85.6%, 81.1% and 75.4% in three above groups, respectively), especially among new children cases (91.0% vs. 69.6% in previously treated cases, P =0.03). The prevalence of the Beijing genotype isolates was higher in northern and central China in the total collection (85.1% in northern and 83.9% in central vs. 61.6% in southern China, P <0.001) and a similar trend was seen in all three age groups (P =0.708, < 0.001 and 0.025, respectively). In adolescents, the frequencies of isoniazid (INH)-resistant and ethambutol (EMB)-resistant isolates were significantly higher among Beijing strains compared to non-Beijing genotype strains (P =0.028 for INH and P=0.027 for EMB). Furthermore, strong association was observed between resistance to rifampicine (RIF), streptomycin (STR) and multidrug resistance (MDR) among Beijing compared to non-Beijing strains in previously treated cases of children (P =0.01, 0.01 and 0.025, respectively). Conclusion: Beijing family was more prevalent in northern and central China compared to southern China and these strains were predominant in all age groups. The genetic diversity of M. tuberculosis isolates from childrenwas similar to that found in adolescents and adults. Beijing genotypewas associatedwith RIF, STR andMDR resistance in previously treated children.
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