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Tuberculosis in Buenos Aires: ten-month analysis at a reference hospital

Abstract number: P1948

Gonzalo X., Ambroggi M., Velji P., Córdoba E., Brown T., Poggi S., Paz S., Pion M., Drobniewski F., Waisman J.

Objectives: (1) Assess the molecular epidemiology of Mycobacterium tuberculosis at an infectious disease reference hospital in Argentina. (2) Investigate the prevalence of drug resistance and the underlying genetic background for this.

Methods: 157 patients were enrolled, 57 multi drug resistant (MDR) and 100 fully susceptible. Spoligotyping, VNTR 15 (Variable Number Tandem Repeats), VNTR 7, SNP (Silent Nucleotide Polymorphism) detection using macroarrays and rpoB gene sequencing were performed. Clinical data were collected using a structured questionnaire.

Results: The 157 patients were mainly argentines that lived either in Buenos Aires City or in Greater Buenos Aires; 33% were HIV (human immunodeficiency virus) positive. 62% presented with pulmonary tuberculosis (TB), 80% had a positive smear and 86% of the chest x-rays were abnormal. 18 spoligo families were found. 84% of the 157 strains were clustered in 7 families. When combined with VNTR 15 results, 32% of the strains remained clustered in 3 groups. After adding VNTR data, 2 clusters survived with 12% and 5% of the strains respectively. The 57 MDR strains belonged to 25 HIV positive patients, 25 HIV negative ones and 7 with unknown serologic status. They belonged to 13 spoligo families, 75% were katG mutants whereas 9% were inh mutants. 56 out of 57 had an rpoB mutation. The number of drugs to which bacteria were resistant ranged from 2 to 10.

Conclusions: MDR TB at the Muñiz hospital was mainly represented by 4 spoligo families, with the Haarlem 2 family significantly related to resistance. There was a correlation between the number of drugs to which the strain was resistant and the number of treatments taken showing that compliance is still a major problem in the TB patient management at this hospital.

Session Details

Date: 19/04/2008
Time: 00:00-00:00
Session name: 18th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Barcelona, Spain
Presentation type:
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