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High clustering rates of multidrug-resistant Mycobacterium tuberculosis genotypes in Panama

Samantha Rosas14, Jaime Bravo1, Franklin Gonzalez1, Nora de Moreno2, Joel Sanchez3, Ronnie G Gavilan3 and Amador Goodridge4*

Author Affiliations

1 Laboratorio Central de Referencia de Salud Pública, Instituto Conmemorativo Gorgas de Estudios de la Salud Pública, Vía Justo Arosemena, Panama, Panama

2 Departamento de Microbiología, Facultad de Medicina, Universidad de Panamá, Vía Transístmica, Panama, Panama

3 Centro de Biodiversidad y Descubrimiento de Drogas-Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Ciudad Del Saber, Panama, Panama

4 Centro de Biología Celular y Molecular de Enfermedades, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT-AIP), Ciudad Del Saber, Panama, Panama

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BMC Infectious Diseases 2013, 13:442  doi:10.1186/1471-2334-13-442

Published: 23 September 2013



Tuberculosis continues to be one of the leading causes of death worldwide and in the American region. Although multidrug-resistant tuberculosis (MDR-TB) remains a threat to TB control in Panama, few studies have focused in typing MDR-TB strains. The aim of our study was to characterize MDR Mycobacterium tuberculosis clinical isolates using PCR-based genetic markers.


From 2002 to 2004, a total of 231 Mycobacterium tuberculosis isolates from TB cases country-wide were screened for antibiotic resistance, and MDR-TB isolates were further genotyped by double repetitive element PCR (DRE-PCR), (GTG)5-PCR and spoligotyping.


A total of 37 isolates (0.85%) were resistant to both isoniazid (INH) and rifampicin (RIF). Among these 37 isolates, only two (5.4%) were resistant to all five drugs tested. Dual genotyping using DRE-PCR and (GTG)5-PCR of MDR Mycobacterium tuberculosis isolates revealed eight clusters comprising 82.9% of the MDR-TB strain collection, and six isolates (17.1%) showed unique fingerprints. The spoligotyping of MDR-TB clinical isolates identified 68% as members of the 42 (LAM9) family genotype.


Our findings suggest that MDR Mycobacterium tuberculosis is highly clustered in Panama’s metropolitan area corresponding to Panama City and Colon City, and our study reveals the genotype distribution across the country.

Mycobacterium tuberculosis; Multidrug-resistant tuberculosis (MDR-TB); DRE-PCR; (GTG)5-PCR; Spoligotyping