RT Journal Article
SR Electronic
T1 Transmission of MDR-TB by a Haarlem genotype mycobacterium tuberculosis strain among native Greeks
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4685
VO 42
IS Suppl 57
A1 Stamatoula Tsikrika
A1 Panagiotis Ioannidis
A1 Dimitris Papaventsis
A1 Apostolos Papavasileiou
A1 Simona Karabela
A1 Ioanna Marinou
A1 Eythymia Konstantinidou
A1 Anastasios Skouroglou
A1 Jessica De Beer
A1 Madeline Stone
A1 Dick van Soolingen
A1 Francis Drobniewski
A1 Kostantinos Kostantinou
A1 Kostantinos Kostantinou
A1 Evangelos Vogiatzakis
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4685.abstract
AB Aim: To study possible transmission of MDR-TB among native Greeks by molecular genotyping of the Mycobacterium tuberculosis isolates.Patients-Methods: Five isolates were retrieved from 4 patients in Athens (3 males and one female; mean age 38y) who were hospitalized between 2009 and 2012. Resistance mutations were traced by using the Genotype MTBDRplus and MTBDRsl assays (Hain Lifescience, Germany). 24-loci VNTR typing was performed to investigate possible transmission in collaboration with the RIVM, The Netherlands, within the framework of an ECDC/RIVM MDR-TB project 2009-2012 and with the NMRL, UK.Results: All patients were HIV seronegative, without immunosuppression or respiratory diseases other than pulmonary TB. Cavitary lesions on X-ray were described in two cases. The M. tuberculosis isolates harbored the rpoB H526D and katG S315T2 mutations. Two strains also had the gyrA A90V mutation; whereas one had a mixed population of wild-type gyrA and gyrA A90V mutated bacilli. Conventional DST confirmed the molecular data. A gradual clinical, radiological and microbiological improvement was observed in all cases. VNTR profiles of the 4 isolates (one from each patient), were unique in the MIRU-VNTR plus and the UK National Database. However, the VNTR profiles were identical or differed in only one locus and thus revealed active transmission of MDR-TB. Two of the patients were indeed close contacts. The isolates were identified as Haarlem lineage strains.Conclusion: This study re-emphasizes the transmissibility of MDR-TB and the need of early case finding and infection control. Molecular epidemiology is a very useful tool to reveal this important issue.