The Beijing genotype is emerging among multidrug-resistant Mycobacterium tuberculosis strains from Germany
OBJECTIVE: To determine the genetic relationship of 451 multidrug-resistant (MDR) Mycobacterium tuberculosis strains from Germany and to identify strains of the Beijing genotype.
DESIGN: All strains were analysed using IS6110 fingerprinting and a cluster analysis was performed. Clustering of isolates was used as a measure for recent transmission.
RESULTS: Two hundred and fourteen of 433 strains (49.4%) with more than four IS6110 copies formed 46 fingerprint clusters comprising two to 32 patients. Transmission links based on classical epidemiological data could be established for 39 cases (18.2%) and in 14 clusters (30.4%), and included three cases of exogenous reinfection with MDR strains. One hundred and seventy-five strains (38.8%) were of the Beijing genotype with an increasing annual proportion from 19.2% in 1995 to 58.3% in 2001. About 70% of these patients had an indication of foreign birth, mainly the former Soviet Union.
CONCLUSION: Transmission of MDR strains seems to be contributing to the spread of MDR-TB in Germany, and exogenous reinfection with MDR strains must be considered as a possible cause of treatment failure. A high proportion of these MDR strains is probably carried over from the former Soviet Union, and strains of the Beijing genotype represent an increasing cause of MDR-TB in Germany.
Document Type: Regular Paper
Affiliations: Forschungszentrum Borstel, National Reference Center for Mycobacteria, Borstel, Germany
Publication date: 01 September 2004
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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