Abstract
BackgroundDrug-resistant tuberculosis (TB) continues to be a public health threat. There are few studies on transmission and genotyping of MDR-TB family households in China. This study aimed to investigate transmission of multidrug-resistant tuberculosis (MDR-TB) within family households by deletion-targeted multiplex polymerase chain reaction (DTM-PCR), mycobacterial interspersed repetitive unit variable number tandem repeats (MIRU-VNTR) genotyping.MethodsAmong 993 MDR-TB patients registered from Wuhan Institute for Tuberculosis Control, drug resistance and the time interval between the index patients and secondary patients were analyzed in 49 MDR-TB patients from 23 families, in which 22 MDR-TB strains from 11 families who had matched strains were genotyped by DTM-PCR and standard 24-loci MIRU-VNTR genotyping method.ResultsThe time interval between the index patients and the secondary patients ranged from half a month to 110 months. Thirteen secondary patients developed active MDR-TB within two years and accounted for 50% (13/26) of all secondary patients. Among eleven pairs of MDR-TB families, six pairs had identical genotypes, the cluster rate was 54.5% (12/22); three pairs had a single MIRU-VNTR locus variation. If a single MIRU-VNTR locus variation was tolerated in the cluster definition, the cluster rate raised to 81.8% (18/22).ConclusionsThe family households of MDR-TB patients are at risk for infection of MDR-TB. To reduce transmission, MDR-TB patients should be diagnosed earlier and promptly treated in an effective manner, meanwhile, the close family contacts should be screened for TB infection.
Highlights
IntroductionThere are few studies on transmission and genotyping of multidrug-resistant tuberculosis (MDR-TB) family households in China
Drug-resistant tuberculosis (TB) continues to be a public health threat
Owing to its shorter turnaround and simple numerical nomenclature system, mycobacterial interspersed repetitive unit variable number tandem repeats (MIRU-VNTR) genotyping, which is based on 24 standardized loci has replaced Insert sequence 6110 (IS6110) Deoxyribonucleic acid (DNA) fingerprinting over the last decade as a gold standard among classical strain typing methods for many applications [5]
Summary
There are few studies on transmission and genotyping of MDR-TB family households in China. This study aimed to investigate transmission of multidrug-resistant tuberculosis (MDR-TB) within family households by deletion-targeted multiplex polymerase chain reaction (DTM-PCR), mycobacterial interspersed repetitive unit variable number tandem repeats (MIRU-VNTR) genotyping. Owing to its shorter turnaround and simple numerical nomenclature system, mycobacterial interspersed repetitive unit variable number tandem repeats (MIRU-VNTR) genotyping, which is based on 24 standardized loci has replaced IS6110 DNA fingerprinting over the last decade as a gold standard among classical strain typing methods for many applications [5]. The deletion-targeted multiplex polymerase chain reaction (DTM-PCR), which is faster and easier to perform, has been considered as a good alternative method to Spoligotyping to identify Mycobacterium tuberculosis Beijing strains. The Beijing genotype is predominant among MDR-TB strain in China [6, 7]
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