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Volume 15, Number 2—February 2009

Dispatch

Vaccine-induced Immunity Circumvented by Typical Mycobacterium tuberculosis Beijing Strains

Kristin KremerComments to Author , Marieke J. van der Werf, Betty K.Y. Au, Dang D. Anh, Kai M. Kam, H. Rogier van Doorn, Martien W. Borgdorff, and Dick van Soolingen
Author affiliations: National Institute for Public Health and the Environment, Bilthoven, the Netherlands (K. Kremer, B.K.Y. Au, D. van Soolingen); KNCV Tuberculosis Foundation, The Hague, the Netherlands (M.J. van der Werf, M.W. Borgdorff); National Institute of Hygiene and Epidemiology, Hanoi, Vietnam (D.D. Anh); Department of Health, Hong Kong Special Administrative Region, People’s Republic of China (K.M. Kam); University of Amsterdam, Amsterdam, the Netherlands (H.R. van Doorn, M.W. Borgdorff)

Main Article

Table 2

Risk factors for drug resistance of Mycobacterium tuberculosis Beijing clade strains in 678 persons with tuberculosis, Vietnam and the Netherlands*

Risk factor Total no. patients Resistance, % patients
Adjusted odds ratio (95% confidence interval)†
Multidrug INH SM Multidrug INH SM
Genotype
Typical Beijing 523 2.9 17.6 28.7 1 1 1
Atypical Beijing 155 7.1 25.5 21.3 2.48 (1.09-5.65) 1.58 (1.00–2.49) 0.59 (0.37–0.93)
Country
Vietnam 268 6.7 32.1 44.0 1 1 1
The Netherlands 410 2.0 11.0 15.9 0.21 (0.06–0.76) 0.20 (0.11–0.34) 0.21 (0.13–0.33)
Sex
M 415 3.6 18.6 28.0 1 1 1
F 219 2.7 19.2 22.4 0.91 (0.34–2.44) 1.34 (0.86–2.11) 0.87 (0.58–1.31)
Unknown 44 11.4 27.3 40.9 2.39 (0.67–8.54) 0.90 (0.41–1.97) 0.88 (0.43–1.78)
Age, y
<25 164 3.7 13.4 25.0 1 1 1
25–34 215 4.7 24.7 28.4 0.93 (0.32–2.70) 1.76 (1.00–3.12) 0.94 (0.57–1.54)
35–44 140 4.3 25.0 30.0 0.71 (0.21–2.41) 1.46 (0.78–2.74) 0.82 (0.47–1.43)
45–54 51 3.9 17.6 33.3 0.68 (0.12–3.77) 0.91 (0.37–2.27) 0.92 (0.44–1.95)
55–64 36 2.8 16.7 27.8 0.60 (0.07–5.45) 0.99 (0.35–2.81) 1.05 (0.44–2.52)
65–74 50 2.0 10.0 16.0 0.40 (0.04–3.66) 0.63. (022–1.85) 0.57 (0.23–1.39)
>75 22 0 4.5 18.2 -- 0.31 (0.04–2.50) 1.06 (0.32–3.49)
BCG vaccination
No 249 4.0 22.1 28.9 1 1 1
Yes 265 4.2 19.6 30.9 0.63 (0.22–1.83) 0.71 (0.43–1.17) 0.99 (0.63–1.54)
Unknown 164 3.0 14.6 17.7 2.44 (0.54–11.04) 1.64 (0.84–3.21) 1.26 (0.70–2.24)
Total 678 26 131 183

*INH, isoniazid; SM, streptomycin; BCG, Mycobacterium bovis bacillus Calmette-Guérin.
†Adjusted for genotype, country, sex, age group, and BCG vaccination.

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