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dc.contributor.author | Sheen Cortavarria, Patricia | |
dc.contributor.author | Couvin, David | |
dc.contributor.author | Grandjean, Louis | |
dc.contributor.author | Zimic-Peralta, Mirko Juan | |
dc.contributor.author | Dominguez, Maria | |
dc.contributor.author | Luna, Giannina | |
dc.contributor.author | Gilman, Robert Hugh | |
dc.contributor.author | Rastogi, Nalin | |
dc.contributor.author | Moore, David Alexander James | |
dc.date.accessioned | 2022-01-04T20:31:48Z | |
dc.date.available | 2022-01-04T20:31:48Z | |
dc.date.issued | 2013 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12866/10680 | |
dc.description.abstract | Background: There is limited available data on the strain diversity of M tuberculosis in Peru, though there may be interesting lessons to learn from a setting where multidrug resistant TB has emerged as a major problem despite an apparently well-functioning DOTS control programme. Methods: Spoligotyping was undertaken on 794 strains of M tuberculosis collected between 1999 and 2005 from 553 community-based patients and 241 hospital-based HIV co-infected patients with pulmonary tuberculosis in Lima, Peru. Phylogenetic and epidemiologic analyses permitted identification of clusters and exploration of spoligotype associations with drug resistance. Results: Mean patient age was 31.9 years, 63% were male and 30.4% were known to be HIV+. Rifampicin mono-resistance, isoniazid mono-resistance and multidrug resistance (MDR) were identified in 4.7%, 8.7% and 17.3% of strains respectively. Of 794 strains from 794 patients there were 149 different spoligotypes. Of these there were 27 strains (3.4%) with novel, unique orphan spoligotypes. 498 strains (62.7%) were clustered in the nine most common spoligotypes: 16.4% SIT 50 (clade H3), 12.3% SIT 53 (clade T1), 8.3% SIT 33 (LAM3), 7.4% SIT 42 (LAM9), 5.5% SIT 1 (Beijing), 3.9% SIT 47 (H1), 3.0% SIT 222 (clade unknown), 3.0% SIT1355 (LAM), and 2.8% SIT 92 (X3). Amongst HIV-negative community-based TB patients no associations were seen between drug resistance and specific spoligotypes; in contrast HIV-associated MDRTB, but not isoniazid or rifampicin mono-resistance, was associated with SIT42 and SIT53 strains. Conclusion: Two spoligotypes were associated with MDR particularly amongst patients with HIV. The MDR-HIV association was significantly reduced after controlling for SIT42 and SIT53 status; residual confounding may explain the remaining apparent association. These data are suggestive of a prolonged, clonal, hospital-based outbreak of MDR disease amongst HIV patients but do not support a hypothesis of strain-specific propensity for the acquisition of resistance-conferring mutations. | en_US |
dc.language.iso | eng | |
dc.publisher | Public Library of Science | |
dc.relation.ispartofseries | PLoS ONE | |
dc.rights | info:eu-repo/semantics/restrictedAccess | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es | |
dc.subject | Humans | en_US |
dc.subject | Peru | en_US |
dc.subject | Directly Observed Therapy | en_US |
dc.subject | Antitubercular Agents | en_US |
dc.subject | Phylogeny | en_US |
dc.subject | Drug Resistance | en_US |
dc.subject | Isoniazid | en_US |
dc.subject | Mycobacterium tuberculosis | en_US |
dc.subject | Rifampin | en_US |
dc.subject | Tuberculosis | en_US |
dc.title | Genetic Diversity of Mycobacterium tuberculosis in Peru and Exploration of Phylogenetic Associations with Drug Resistance | en_US |
dc.type | info:eu-repo/semantics/article | |
dc.identifier.doi | https://doi.org/10.1371/journal.pone.0065873 | |
dc.subject.ocde | https://purl.org/pe-repo/ocde/ford#1.06.01 | |
dc.relation.issn | 1932-6203 |
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