Rifampin- and multidrug-resistant tuberculosis in Russian civilians and prison inmates: dominance of the beijing strain family

• Published in: Emerging infectious diseases 2002-11, Vol.8 (11), p.1320-1326
• Main Authors: Drobniewski, Francis, Balabanova, Yanina, Ruddy, Michael, Weldon, Laura, Jeltkova, Katya, Brown, Timothy, Malomanova, Nadezdna, Elizarova, Elvira, Melentyey, Alexander, Mutovkin, Ebgeny, Zhakharova, Svetlana, Fedorin, Ivan
• Format: Article
• Language: English
• Subjects: Antitubercular Agents - pharmacology; Antitubercular Agents - therapeutic use; China; Drug resistance; Drug Resistance, Multiple, Bacterial; Female; Health aspects; Humans; Isoniazid; Male; Minisatellite Repeats; Mutation; Mycobacteria; Mycobacterium tuberculosis - classification; Mycobacterium tuberculosis - drug effects; Mycobacterium tuberculosis - genetics; Mycobacterium tuberculosis - isolation & purification; Prisoners; Rifampin; Rifampin - pharmacology; Rifampin - therapeutic use; Russia; Russia - epidemiology; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis - microbiology
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid0811.020507

Consecutive patient cultures (140) of Mycobacteriium tuberculosis were collected from five Russian civilian and prison tuberculosis laboratories and analyzed for rifampin (rpoB) and isoniazid resistance (inhA, katG, ahpC); transmission of Beijing family isolates; and the importance of prison and previous therapy in drug resistance. Rifampin, isoniazid, and multidrug resistance occurred in 58.2%, 51.6%, and 44.7% of cultures, respectively; 80% of prison cultures were rifampin resistant. Spoligotyping and variable number tandem repeat (VNTR) fingerprinting divided the isolates into 43 groups. Spoligotyping demonstrated that a high proportion (68.1%) of patients were infected with Beijing family strains and that most (69.1%) were rifampin resistant; the highest proportion (81.6%) occurred in prison. One VNTR subgroup (42435) comprised 68 (72.3%) of the Beijing isolates with a small number of IS6110 types; 50 (73.5%) were rifampin resistant. Rifampin-resistant Beijing isolates are dominant within the patient population, especially among prisoners, and threaten treatment programs.