Article
Mycobacterium tuberculosis of the RDRio Genotype Is the Predominant Cause of Tuberculosis and Associated with Multidrug Resistance in Porto Alegre City, South Brazil
Registro en:
COSTA, Elis Regina Dalla; Mycobacterium tuberculosis of the RDRio Genotype Is the Predominant Cause of Tuberculosis and Associated with Multidrug Resistance in Porto Alegre City, South Brazil. Journal of Clinical Microbiology, v.51, n.4, p. 1071–1077, April 2013.
10.1128/JCM.01511-12
Autor
Costa, Elis Regina Dalla
Lazzarini, Luiz Claudio Oliveira
Perizzolo, Paulo Fernando
Diaz, Chyntia Acosta
Spies, Fernanda S.
Costa, Lucas Laux
Ribeiro, Andrezza W.
Barroco, Caroline
Schuh, Sandra Jungblut
Pereira, Maria Aparecida da Silva
Dias, Claudia F.
Gomes, Harrison M.
Unis, Gisela
Zaha, Arnaldo
Silva, Pedro E. Almeida da
Suffys, Phillip
Rossetti, Maria L. R.
Resumen
Spoligotyping has shown Mycobacterium tuberculosis strains to be composed of different lineages, and some of them are not just
geographically restricted but also affect specific ethnic populations and are associated with outbreaks and drug resistance. We
recently described a particular subtype within the Latin American-Mediterranean (LAM) family, called RDRio, widespread in
Brazil. Moreover, recent data also indicate that RDRio is present in many countries on all continents and is associated with cavitary
disease and multidrug resistance (MDR). To further explore the relationship between RDRio and MDR, we conducted a
study in a tuberculosis (TB) reference center responsible for the care of MDR patients in Rio Grande do Sul, the southernmost
Brazilian state. From a collection of 237 clinical isolates, RDRio alone was responsible for one-half of all MDR cases, including
one large group composed of strains with identical IS6110-restriction fragment length polymorphism (RFLP) and having the
LAM5 signature. We additionally had complete data records for 96 patients and could make comparisons between the presence
and absence of RDRio. No difference in clinical, radiological or laboratory features was observed, but a significantly greater number
of cases with MDR were described in patients infected with an RDRio strain (P 0.0015). Altogether, RDRio was responsible
for 38% of all TB cases. These data support and confirmed previous findings that RDRio is the main agent responsible for TB in
Brazil and is associated with drug resistance. Considering that RDRio is a globally distributed genotype, such findings raise concern
about the increase in MDR in certain human populations.