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Changes in MIRU-VNTR profiles are associated with treatment failures in tuberculosis patients

Irina Kontsevaya, Vladyslav Nikolayevskyy, Alexander Kovalyov, Olga Ignatyeva, Edita Vasiliauskiene, Girts Skenders, Yanina Balabanova, Francis Drobniewski
European Respiratory Journal 2016 48: PA2684; DOI: 10.1183/13993003.congress-2016.PA2684
Irina Kontsevaya
1Infectious Diseases and Immunity, Imperial College London, London, United Kingdom
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Vladyslav Nikolayevskyy
1Infectious Diseases and Immunity, Imperial College London, London, United Kingdom
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Alexander Kovalyov
2Bacteriological Laboratory, N.V. Postnikov Samara Region Clinical Tuberculosis Dispensary, Samara, Russian Federation
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Olga Ignatyeva
2Bacteriological Laboratory, N.V. Postnikov Samara Region Clinical Tuberculosis Dispensary, Samara, Russian Federation
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Edita Vasiliauskiene
3Infectious Diseases and TB Hospital, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
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Girts Skenders
4Center of Tuberculosis and Lung Diseases, Riga East Clinical University Hospital, Riga, Latvia
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Yanina Balabanova
1Infectious Diseases and Immunity, Imperial College London, London, United Kingdom
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Francis Drobniewski
1Infectious Diseases and Immunity, Imperial College London, London, United Kingdom
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Abstract

Background: Superinfection by M. tuberculosis more frequently occurs in high drug-resistant tuberculosis (TB) areas due to a large pool of chronic patients and poor infection control. The aim of the study was to estimate the superinfection rate in a multicentre TB patient cohort from a high drug-resistant TB burden regions and whether superinfection affects disease outcome.

Methods: The study population included 513 serial M. tuberculosis isolates (2 to 8 per patient) obtained from 84 multi-drug resistant (MDR) and 136 non-MDRTB patients recruited sequentially at sites in Lithuania, Latvia and Russia; treatment outcomes were available for 173 of them. Strains were genotyped using standardised 24-loci MIRU-VNTR typing.

Results: Changes in two or more VNTR loci suggesting superinfection were seen in strains isolated from 13 (8 non-MDRTB; 5 MDRTB) patients (5.9%). As a whole this group had higher treatment failure rates compared to other patients (5/13, 38.5% vs 26/160, 16.2%, RR=2.4, 95% CI=1.1-5.1). Non-MDRTB patients infected with a second TB strain had higher (although not significant) treatment failure rate (2/8, 25.0% vs 10/109, 9.2%, RR=2.7, 95% CI=0.7-10.4); MDRTB patients infected with a second strain showed similar rates of treatment failure as those not superinfected.

Conclusion: A proportion of patients in high drug-resistant TB burden areas get superinfected with another TB strain during anti-TB treatment; the superinfection might be associated with higher failure rates in non-MDRTB patients.

  • Epidemiology
  • MDR-TB
  • Genetics
  • Copyright ©the authors 2016
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Changes in MIRU-VNTR profiles are associated with treatment failures in tuberculosis patients
Irina Kontsevaya, Vladyslav Nikolayevskyy, Alexander Kovalyov, Olga Ignatyeva, Edita Vasiliauskiene, Girts Skenders, Yanina Balabanova, Francis Drobniewski
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2684; DOI: 10.1183/13993003.congress-2016.PA2684

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Changes in MIRU-VNTR profiles are associated with treatment failures in tuberculosis patients
Irina Kontsevaya, Vladyslav Nikolayevskyy, Alexander Kovalyov, Olga Ignatyeva, Edita Vasiliauskiene, Girts Skenders, Yanina Balabanova, Francis Drobniewski
European Respiratory Journal Sep 2016, 48 (suppl 60) PA2684; DOI: 10.1183/13993003.congress-2016.PA2684
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