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Volume 19, Number 3—March 2013

Research

Emergence and Spread of Extensively and Totally Drug-Resistant Tuberculosis, South Africa

Marisa Klopper, Robin Mark WarrenComments to Author , Cindy Hayes, Nicolaas Claudius Gey van Pittius, Elizabeth Maria Streicher, Borna Müller, Frederick Adriaan Sirgel, Mamisa Chabula-Nxiweni, Ebrahim Hoosain, Gerrit Coetzee, Paul David van Helden, Thomas Calldo Victor, and André Phillip Trollip
Author affiliations: Author affiliations: Stellenbosch University, Cape Town, South Africa (M. Klopper, R.M. Warren, N.C. Gey van Pittius, E.M. Streicher, B. Müller, F.A. Sirgel, P.D. van Helden, T.C. Victor, AP.. Trollip); National Health Laboratory Services, Port Elizabeth, South Africa (C. Hayes, G. Coetzee); Swiss Tropical and Public Health Institute, Basel, Switzerland (B. Müller); University of Basel, Basel (B. Müller); Nelson Mandela Metropolitan Municipality, Port Elizabeth (M. Chabula-Nxiweni); Human Sciences Research Council, Port Elizabeth (E. Hoosain)

Main Article

Table 1

Spoligotype classification of drug-sensitive and MDR TB isolates, Eastern Cape Province, South Africa, 2008–2009*

Spoligotype family†
ST no.
Culture-based DST, no. (%)
Molecular-based DST, no. (%)
Sensitive
MDRss
Pre-XDR
XDR

MDRss
Pre-XDR
XDR
Atypical Beijing 1 11 (3.6) 41 (27.0) 98 (92.5) 78 (92.9) 29 (22.5) 85 (87.6) 103 (95.4)
Typical Beijing 1 108 (35.0) 19 (12.5) 0 0 18 (14.0) 1 (1.0) 0
H 36; 47; 50; 62 7 (2.3) 2 (1.3) 1 (0.9) 0 2 (1.6) 1 (1.0) 0
LAM3 33; 130; 211 66 (21.4) 12 (7.9) 2 (1.9) 0 12 (9.3) 0 (0) 0
LAM4 60; 811 6 (1.9) 32 (21.1) 4 (3.8) 2 (1.9) 29 (22.5) 3 (3.1) 2 (1.9)
LAM (other) 4; 20; 42; 398 7 (2.3) 1 (0.7) 0 1 (1.2) 1 (0.8) 0 1 (0.9)
MANU2 1247 0 0 0 2 (2.4) 1 (0.8) 0 1 (0.9)
S 34; 71 8 (2.6) 8 (5.3) 0 1 (1.2) 8 (6.2) 0 1 (0.9)
T 44; 53; 73; 254; 926; 1240 51 (16.5) 18 (11.8) 0 0 13 (10.1) 5 (5.2) 0
U 443; 519; 790 1 (0.3) 2 (1.3) 0 0 2 (1.6) 0 0
X 18; 92; 119; 1751 6 (1.9) 3 (2.0) 0 0 3 (2.3) 0 0
CAS 21; 26; 1092 4 (1.3) 0 0 0 0 0 0
Orphan Not assigned 34 (11.0) 14 (9.2) 1 (0.9) 0 11 (8.5) 2 (2.1) 0
Total 309 152 106 84 129 97 108
Total MDR 342 334‡

*MDR TB, multidrug-resistant tuberculosis; ST, shared type (17); DST, drug susceptibility testing; MDRss, MDR sensu stricto; Pre-XDR, pre–extensively drug resistant; XDR, extensively drug resistant.
†For Beijing isolates a distinction was made between typical and atypical based on the presence or absence of an IS6110 insertion in the noise transfer region (18,19).
‡Molecular-based DST total differs from culture-based DST total, because some results were not available.

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