engleski

Molecular epidemiology of multidrug resistant tuberculosis in Croatia 1999-2007

Objective: Multidrug resistant (MDR) tuberculosis is by definition resistant to rifampicin (RIF) and isoniazid (INH) or their combinations with other antituberculous drugs. The aim of this molecular-epidemiologic study was to determine genetic basis of resistance to RIF and INH and to identify the possible transmission of MDR tuberculosis. Methods: MDR strains determined by the Canetti’ s method were collected. These strains were isolated in 69 patients in Croatia from 1999 to 2007. MDR strains were genotyped by the MIRU-VNTR (Mycobacterial Interspersed Repetitive Units - Variable Number of Tandem Repeats) method. Mutations in rpoB, katG and inhA genes were tested using the Genotype MTBDR test (Hain Lifescience) and the multiplex PCR method using specific primers. Results: Genotyping by the MIRU-VNTR method identified 47 strains as belonging to specific clusters, while 22 strains had a unique genotype each. Same clustering results were obtained using either 15 or 24 VNTR loci. It was possible to determine the genetic basis of the resistance to RIF and INH in 67 (97.1%) and 44 (63.8%) strains, respectively. Conclusion: It can be presumed that clustered strains partly represent the transmission of primarily resistant strains. All newly isolated MDR M. tuberculosis strains in Croatia have to be continuously monitored with care in order to stop the transmission of these strains on time.

Mycobacterium tuberculosis; resistance; MIRU-VNTR

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