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Volume 18, Number 8—August 2012

Dispatch

Drug-Resistant Tuberculosis Transmission and Resistance Amplification within Families

James A. SeddonComments to Author , Rob M. Warren, Donald A. Enarson, Nulda Beyers, and H. Simon Schaaf
Author affiliations: London School of Hygiene and Tropical Medicine, London, UK (J.A. Seddon); Stellenbosch University, Tygerberg, South Africa (J.A. Seddon, R.M. Warren, N. Beyers, H.S. Schaaf); International Union Against Tuberculosis and Lung Disease, Paris, France (D.A, Enarson); and Tygerberg Children’s Hospital, Tygerberg (H.S. Schaaf)

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Table

Gene sequencing, IS6110 DNA fingerprinting, and genotype results for isolates from members of 2 families with drug-resistant tuberculosis, South Africa, 2008–2010*

Family and family member ID no. Gene†
IS6110 cluster no.
rpoB
inhA
katG
embB
gyrA
pncA
rrs 1401
R H H E F Z A
Family 1

Uncle’s mother

A1 531, TCG→TTG WT 315, AGC→ACC 306, ATG→ATA 90, GCG→GTG 160, ACA→GCA; 100, ACC→ATC WT 213

Uncle

A2 531, TCG→TTG WT 315, AGC→ACC 306, ATG→ATA 90, GCG→GTG 160, ACA→GCA; 100, ACC→ATC WT 213

Index child

A3 531, TCG→TTG WT 315, AGC→ACC 306, ATG→ATA 90, GCG→GTG 160, ACA→GCA; 100, ACC→ATC WT §
Family 2

Oldest brother‡

B1

Sister

B2 531, TCG→TTG WT 315, AGC→ACC 306, ATG→ATA 90, GCG→GTG 160, ACA→GCA; 100, ACC→ATC WT 213

Mother

B3 531, TCG→TTG WT 315, AGC→ACC 306, ATG→ATA 90, GCG→GTG 160, ACA→GCA; 100, ACC→ATC 1401, ACG→GCG 213

Other brother

B4 531, TCG→TTG WT 315, AGC→ACC 306, ATG→ATA 90, GCG→GTG 160, ACA→GCA; 100, ACC→ATC 1401, ACG→GCG 213

Index child

B5 531, TCG→TTG WT 315, AGC→ACC 306, ATG→ATA 90 GCG→GTG 160, ACA→GCA; 100, ACC→ATC 1401, ACG→GCG §

*All isolates were Mycobacteria tuberculosis Beijing genotype. The earliest sample available for each patient is shown; in all instances in which >1 sample was available for a patient, all samples demonstrated identical gene sequence and strain type results. ID, identification; R, rifampin; H, isoniazid; E, ethambutol; F, fluoroquinolones; Z, pyrazinamide; A, aminoglycosides, WT, wild type.
†Numbers indicate specific mutations, which are shown.
‡Tuberculosis developed and patient died before systematic sample collection and storage. No culture or drug susceptibility testing was requested for sample.
§Only spoligotyping performed because isolates repeatedly lost viability on culture.

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