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Open Access Highly Accessed Research article

Molecular epidemiology and evolutionary genetics of Mycobacterium tuberculosis in Taipei

Horng-Yunn Dou1, Fan-Chen Tseng1, Chih-Wei Lin1, Jia-Ru Chang1, Jun-Ren Sun2, Wen-Shing Tsai2, Shi-Yi Lee2, Ih-Jen Su1* and Jang-Jih Lu23*

Author Affiliations

1 Division of Clinical Research, National Health Research Institutes, Zhunan, Taiwan. 35 Keyan Road, Zhunan, Miaoli County 350, Taiwan, Republic of China

2 Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital and National Defense Medical Center, 325 Sec. 2 Chenggong Rd., Taipei 114, Taiwan, Republic of China

3 Department of Laboratory Medicine, China Medical University Hospital, 2, Yuh-Der Road, Taichung 404, Taiwan, Republic of China

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BMC Infectious Diseases 2008, 8:170  doi:10.1186/1471-2334-8-170

Published: 22 December 2008

Abstract

Background

The control of tuberculosis in densely populated cities is complicated by close human-to-human contacts and potential transmission of pathogens from multiple sources. We conducted a molecular epidemiologic analysis of 356 Mycobacterium tuberculosis (MTB) isolates from patients presenting pulmonary tuberculosis in metropolitan Taipei. Classical antibiogram studies and genetic characterization, using mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing and spoligotyping, were applied after culture.

Methods

A total of 356 isolates were genotyped by standard spoligotyping and the strains were compared with in the international spoligotyping database (SpolDB4). All isolates were also categorized using the 15 loci MIRU-VNTR typing method and combin with NTF locus and RD deletion analyses.

Results

Of 356 isolates spoligotyped, 290 (81.4%) displayed known spoligotypes and 66 were not identified in the database. Major spoligotypes found were Beijing lineages (52.5%), followed by Haarlem lineages (13.5%) and EAI plus EAI-like lineages (11%). When MIRU-VNTR was employed, 140 patterns were identified, including 36 clusters by 252 isolates and 104 unique patterns, and the largest cluster comprised 95 isolates from the Beijing family. The combination of spoligotyping and MIRU-VNTR revealed that 236 (67%) of the 356 isolates were clustered in 43 genotypes. Strains of the Beijing family was more likely to be of modern strain and a higher percentage of multiple drug resistance than other families combined (P = 0.08). Patients infected with Beijing strains were younger than those with other strains (mean 58.7 vs. 64.2, p = 0.02). Moreover, 85.3% of infected persons younger than 25 years had Beijing modern strain, suggesting a possible recent spread in the young population by this family of TB strain in Taipei.

Conclusion

Our data on MTB genotype in Taipei suggest that MTB infection has not been optimally controlled. Control efforts should be reinforced in view of the high prevalence of the Beijing strain in young population and association with drug resistance.