Beijing Genotype of Mycobacterium tuberculosis Is Significantly Associated with Human Immunodeficiency Virus Infection and Multidrug Resistance in Cases of Tuberculous Meningitis

• Published in: Journal of Clinical Microbiology 2006-11, Vol.44 (11), p.3934-3939
• Main Authors: Caws, Maxine, Thwaites, Guy, Stepniewska, Kasia, Lan, Nguyen Thi Ngoc, Duyen, Nguyen Thi Hong, Phuong, Nguyen Thi, Huyen, Mai Nguyet Thu, Duy, Phan Minh, Loc, Tran Huu, Chau, Tran Thi Hong, Soolingen, Dick van, Kremer, Kristin, Chau, Nguyen Van Vinh, Chinh, Nguyen Tran, Farrar, Jeremy
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Fundamental and applied biological sciences. Psychology; Genotype; HIV Infections - microbiology; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Medical sciences; Microbiology; Middle Aged; Miscellaneous; Mycobacteriology and Aerobic Actinomycetes; Mycobacterium tuberculosis; Mycobacterium tuberculosis - classification; Mycobacterium tuberculosis - drug effects; Tuberculosis, Meningeal - microbiology; Tuberculosis, Multidrug-Resistant - microbiology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Virology
• ISSN: 0095-1137; 1098-660X; 1098-5530
• DOI: 10.1128/JCM.01181-06

Multidrug-resistant tuberculous meningitis is fatal without rapid diagnosis and use of second-line therapy. It is more common in human immunodeficiency virus (HIV)-positive patients. Beijing genotype strains of Mycobacterium tuberculosis are associated with drug resistance, particularly multidrug resistance, and their prevalence is increasing worldwide. The prevalence of Beijing genotype strains among Mycobacterium tuberculosis isolates from the cerebrospinal fluid of HIV-positive (n = 35) and HIV-negative (n = 187) patients in Ho Chi Minh City was determined. The Beijing genotype was significantly associated with HIV status (odds ratio [OR] = 2.95 [95% confidence interval {CI}, 1.38 to 6.44]; P = 0.016), resistance to any drug (OR = 3.34 [95% CI, 1.87 to 5.95]; P < 0.001) and multidrug resistance (Fisher's exact test; P = 0.001). The association of the Beijing genotype with drug resistance was independent of HIV status. This is the first report of Beijing genotype association with HIV status, which may be an association unique to tuberculous meningitis.