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Volume 18, Number 11—November 2012
Research

HIV Infection and Geographically Bound Transmission of Drug-Resistant Tuberculosis, Argentina

Viviana RitaccoComments to Author , Beatriz López, Marta Ambroggi, Domingo Palmero, Bernardo Salvadores, Elida Gravina, Eduardo Mazzeo, Susana Imaz, Lucía Barrera, and National TB Laboratory Network
Author affiliations: Instituto Nacional de Enfermedades Infecciosas ANLIS “Dr. Carlos G. Malbrán,” Buenos Aires, Argentina (V. Ritacco, B. López, E. Mazzeo, L. Barrera); Hospital “Dr. F.J. Muñiz,” Buenos Aires (M. Ambroggi, D. Palmero); Programa Provincial de Tuberculosis, Santa Fe, Argentina (B. Salvadores); Hospital Zonal General Agudos “Dr. Diego Paroissien,” La Matanza, Argentina (E. Gravina); and Instituto Nacional de Enfermedades Respiratorias “Dr. Emilio Coni” ANLIS “Dr Carlos G Malbran,” Santa Fe (S. Imaz)

Main Article

Table 3

Putative risk factors for case-patients with newly diagnosed multidrug-resistant TB in 7 major genotype clusters, Argentina 2003–2009

Cluster
(SIT)* Area Total no. case-patients Risk factor, no. (%) case-patients
Previously treated for TB HIV positive HCWs Other hospital exposure† Prison Household
exposure Unknown
M H2 (2) Buenos Aries 228 78 (34.2) 116 (50.9) 21 (9.2) 38 (16.7) 23 (10.1) 29 (12.7) 19 (8.3)
Ra LAM3 (33) Rosario 89 40 (44.9) 28 (31.5) 2 (2.2) 10 (11.2) 17 (19.1) 16 (18.0) 14 (15.7)
Rb Tuscany
(159) Buenos Aries, Rosario 38 11 (28.9) 22 (57.9) 0 (0.0) 1 (2.6) 0 (0.0) 13‡ (34.2) 6 (15.8)
Pr LAM9 (42) Buenos Aries 26 10 (38.5) 10 (38.5) 0 (0.0) 2 (7.7) 15 (57.7) 5 (19.2) 2 (7.7)
At T1 (53) Atlantic Coast 21 9 (42.9) 7 (33.3) 1 (4.8) 3 (14.3) 2 (9.5) 7 (33.3) 2 (9.5)
Ob LAM5 (725) Buenos Aries 18 7 (38.9) 4 (22.2) 0 (0.0) 2 (11.1) 3 (16.7) 5 (27.8) 2 (11.1)
Os LAM5 (93) Salta 18 7 (38.9) 6 (33.3) 0 (0.0) 3 (16.7) 1 (5.6) 9 (50.0) 2 (11.1)

*Sum does not equal total because of patients with more than one risk factor. Buenos Aires includes the city and surroundings. MDR, multidrug-resistant; TB, tuberculosis; SIT, Shared International Spoligo Type according to Brudey et al. (13); HCW, health care workers.
†Previous hospitalization(s) or concomitant condition.
‡Ten of these case-patients shared a single residence with transvestite sex workers.

Main Article

References
  1. de Kantor  IN, Ritacco  V, Barrera  L. Is multidrug-resistant tuberculosis an emergent infection in Buenos Aires? [in Spanish]. Medicina (B Aires). 1996;56:1024.PubMedGoogle Scholar
  2. Ritacco  V, Reniero  A, Ambroggi  M, Barrera  LB, López  B, Di Lonardo  M, Inter-hospital spread of multidrug-resistant tuberculosis in Buenos Aires, Argentina. Tuber Lung Dis. 1996;77(Suppl 2):63.
  3. Morcillo  N, Alito  A, Romano  MI, Cataldi  A, Dolmann  A, Reniero  A, Multidrug resistant tuberculosis outbreak in Buenos Aires. DNA fingerprinting analysis of isolates. Medicina (B Aires). 1996;56:457.PubMedGoogle Scholar
  4. Ritacco  V, Di Lonardo  M, Reniero  A, Ambroggi  M, Barrera  L, Dambrosi  A, Nosocomial spread of Human Immunodeficiency Virus-related multidrug-resistant tuberculosis in Buenos Aires. J Infect Dis. 1997;176:63742. DOIPubMedGoogle Scholar
  5. Poggio  G, Togneri  A, Reniero  A, Insúa  A, Guerra  R, Dinerstein  E, AIDS-related multidrug resistant tuberculosis “M” strain spreads within two hospitals in Buenos Aires suburbs. Int J Tuberc Lung Dis. 1997;1(Supp1):523.PubMedGoogle Scholar
  6. Palmero  D, Ritacco  V, Ambroggi  M, Marcela  N, Barrera  L, Capone  L, Multidrug-resistant tuberculosis in HIV-negative patients, Buenos Aires, Argentina. Emerg Infect Dis. 2003;9:9659. DOIPubMedGoogle Scholar
  7. Aita  J, Barrera  L, Reniero  A, López  B, Biglione  J, Weisburd  G, Hospital transmission of multidrug-resistant Mycobacterium tuberculosis in Rosario, Argentina. Medicina (B Aires). 1996;56:4850.PubMedGoogle Scholar
  8. World Health Organization. Guidelines for surveillance of drug resistance in tuberculosis. WHO/HTM/TB/2009.442. Geneva: The Organization; 2009.
  9. World Health Organization. Policy guidance on TB drug susceptibility testing (DST) of second-line drugs. WHO/HTM/TB/2008.392. Geneva: The Organization; 2008.
  10. van Embden  JDA, Cave  MD, Crawford  JT, Dale  JW, Eisenach  KD, Gicquel  B, Strain identification of Mycobacterium tuberculosis by DNA fingerprinting: recommendations for a standardized methodology. J Clin Microbiol. 1993;31:4069.PubMedGoogle Scholar
  11. Kamerbeek  J, Schouls  L, Kolk  A, van Agterveld  M, van Soolingen  D, Kuijper  S, Simultaneous detection and strain differentiation of Mycobacterium tuberculosis for diagnosis and epidemiology. J Clin Microbiol. 1997;35:90714.PubMedGoogle Scholar
  12. Heersma  HF, Kremer  K, van Embden  J. Computer analysis of IS6110 RFLP patterns of Mycobacterium tuberculosis. Methods Mol Biol. 1998;101:395422.PubMedGoogle Scholar
  13. Brudey  K, Driscoll  JR, Rigouts  L, Prodinger  WM, Gori  A, Al-Hajoj  SA, Mycobacterium tuberculosis complex genetic diversity: mining the fourth international spoligotyping database (SpolDB4) for classification, population genetics and epidemiology. BMC Microbiol. 2006;6:23. DOIPubMedGoogle Scholar
  14. Abadia  E, Zhang  J, dos Vultos  T, Ritacco  V, Kremer  K, Aktas  E, Resolving lineage assignation on Mycobacterium tuberculosis clinical isolates classified by spoligotyping with a new high-throughput 3R SNPs based method. Infect Genet Evol. 2010;10:106674. DOIPubMedGoogle Scholar
  15. Palmero  D, Ritacco  V, Ruano  S, Ambroggi  M, Cusmano  L, Romano  M, Multidrug-resistant tuberculosis outbreak in transvestite sex workers, Buenos Aires, Argentina. Int J Tuberc Lung Dis. 2005;9:116870.PubMedGoogle Scholar
  16. Pando  MA, De Salvo  C, Bautista  CT, Eyzaguirre  L, Carrion  G, Feola  M, Human immunodeficiency virus and tuberculosis in Argentina: prevalence, genotypes and risk factors. J Med Microbiol. 2008;57:1907. DOIPubMedGoogle Scholar
  17. Ritacco  V, Morgado  M, Garcia  LF. The situation of HIV/M. tuberculosis in South America. Open Infect Dis J. 2011, 5, (Suppl 1–M7) 81–88 [cited May 20, 2012]. http://benthamscience.com/open/toidj/articles/V005/SI0013TOIDJ/81TOIDJ.htm
  18. Waisman  JL, Palmero  DJ, Güemes-Gurtubay  JL, Videla  JJ, Moretti  B, Cantero  M, Evaluation of the control measures adopted against an epidemic of AIDS-related multidrug-resistant tuberculosis in a Latin-American hospital [in Spanish]. Enferm Infecc Microbiol Clin. 2006;24:716. DOIPubMedGoogle Scholar
  19. Gonzalo  X, Ambroggi  M, Cordova  E, Brown  T, Poggi  S, Drobniewski  F. Molecular epidemiology of Mycobacterium tuberculosis, Buenos Aires, Argentina. Emerg Infect Dis. 2011;17:52831. DOIPubMedGoogle Scholar
  20. Candia  N, Lopez  B, Zozio  T, Carrivale  M, Diaz  C, Russomando  G, First insight into Mycobacterium tuberculosis genetic diversity in Paraguay. BMC Microbiol. 2007;7:75. DOIPubMedGoogle Scholar
  21. Aristimuño  L, Armengol  R, Cebollada  A, España  M, Guilarte  A, Lafoz  C, Molecular characterisation of Mycobacterium tuberculosis isolates in the First National Survey of Anti-Tuberculosis Drug Resistance from Venezuela. BMC Microbiol. 2006;6:90. DOIPubMedGoogle Scholar
  22. Lazzarini  LC, Huard  RC, Boechat  NL, Gomes  HM, Oelemann  MC, Kurepina  N, Discovery of a novel Mycobacterium tuberculosis lineage that is a major cause of tuberculosis in Rio de Janeiro, Brazil. J Clin Microbiol. 2007;45:3891902. DOIPubMedGoogle Scholar
  23. Ritacco  V, Iglesias  MJ, Ferrazoli  L, Monteserin  J, Dalla Costa  ER, Cebollada  A, Conspicuous multidrug-resistant Mycobacterium tuberculosis cluster strains do not trespass country borders in Latin America and Spain. Infect Genet Evol. 2012;12:7117. DOIPubMedGoogle Scholar
  24. Burgos  MV, Méndez  JC, Ribon  W. Molecular epidemiology of tuberculosis: methodology and applications. Biomedica. 2004;24(Supp1):188201.PubMedGoogle Scholar
  25. Gagneux  S, DeRiemer  K, Van  T, Kato-Maeda  M, de Jong  BC, Narayanan  S, Variable host-pathogen compatibility in Mycobacterium tuberculosis. Proc Natl Acad Sci U S A. 2006;103:286973. DOIPubMedGoogle Scholar
  26. Palmero  D, Ritacco  V, Ambroggi  M, Poggi  S, Güemes Gurtubay  J, Alberti  F, Multidrug-resistant tuberculosis in AIDS patients at the beginning of the millennium. Medicina (B Aires). 2006;66:399404.PubMedGoogle Scholar
  27. Gagneux  S, Long  CD, Small  PM, Van  T, Schoolnik  GK, Bohannan  BJM. The competitive cost of antibiotic resistance in Mycobacterium tuberculosis. Science. 2006;312:19446. DOIPubMedGoogle Scholar
  28. Luciani  F, Sisson  SA, Jiang  H, Francis  AR, Tanaka  MM. The epidemiological fitness cost of drug resistance in Mycobacterium tuberculosis. Proc Natl Acad Sci U S A. 2009;106:147115. DOIPubMedGoogle Scholar
  29. O’Sullivan  DM, McHugh  TD, Gillespie  SH. Mapping the fitness of Mycobacterium tuberculosis strains: a complex picture. J Med Microbiol. 2010;59:15335. DOIPubMedGoogle Scholar
  30. Comas  I, Borrell  S, Roetzer  A, Rose  G, Malla  B, Kato-Maeda  M, Whole-genome sequencing of rifampicin-resistant Mycobacterium tuberculosis strains identifies compensatory mutations in RNA polymerase genes. Nat Genet. 2011;44:10610. DOIPubMedGoogle Scholar

Main Article

1Additional members of the National TB Laboratory Network who contributed data are listed at the end of this article.

Page created: October 16, 2012
Page updated: October 16, 2012
Page reviewed: October 16, 2012
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