1. Tuberculosis relapse in Vietnam is significantly associated with Mycobacterium tuberculosis Beijing genotype infections.
- Author
-
Huyen MN, Buu TN, Tiemersma E, Lan NT, Dung NH, Kremer K, Soolingen DV, and Cobelens FG
- Subjects
- Adult, Aged, Antitubercular Agents therapeutic use, Cohort Studies, Drug Resistance, Multiple, Bacterial drug effects, Female, Follow-Up Studies, Genotype, Humans, Male, Middle Aged, Mycobacterium tuberculosis classification, Mycobacterium tuberculosis genetics, Niacin therapeutic use, Prevalence, Prospective Studies, Recurrence, Rifampin therapeutic use, Rural Population, Streptomycin therapeutic use, Tuberculosis, Multidrug-Resistant drug therapy, Tuberculosis, Multidrug-Resistant microbiology, Vietnam epidemiology, Mycobacterium tuberculosis isolation & purification, Mycobacterium tuberculosis pathogenicity, Tuberculosis, Multidrug-Resistant epidemiology, Tuberculosis, Multidrug-Resistant prevention & control
- Abstract
Background: In Vietnam, the Mycobacterium tuberculosis Beijing genotype is associated with multi-drug resistance and is emerging. A possible explanation for this genotype's success is an increased rate of relapse., Methods: In a prospective cohort study, isolates from patients with smear-positive tuberculosis were subjected to drug susceptibility testing and to spoligotyping and variable number of tandem repeats typing before treatment and after recurrence of tuberculosis., Results: Among 1068 patients who were actively followed up over 18 months for recurrence, 23 relapse cases occurred (1.39 cases/100 person-years). After adjustment for genotype, tuberculosis treatment history, and drug resistance, relapse was significantly associated with the Beijing genotype (adjusted hazard ratio [aHR], 5.48; 95% confidence interval [CI], 2.06-14.55) and isoniazid resistance (aHR, 5.91; 95% CI, 2.16-16.16)., Conclusions: The strongly increased relapse rate in tuberculosis cases caused by Beijing strains probably contributes to the successful spread of this genotype in Vietnam and elsewhere.
- Published
- 2013
- Full Text
- View/download PDF