TY - JOUR AU - Murase, Yoshiro AU - Maeda, Shinji AU - Yamada, Hiroyuki AU - Ohkado, Akihiro AU - Chikamatsu, Kinuyo AU - Mizuno, Kazue AU - Kato, Seiya AU - Mitarai, Satoshi T1 - Clonal Expansion of Multidrug-Resistant and Extensively Drug-Resistant Tuberculosis, Japan T2 - Emerging Infectious Disease journal PY - 2010 VL - 16 IS - 6 SP - 948 SN - 1080-6059 AB - The emergence and spread of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) has raised public health concern about global control of TB. To estimate the transmission dynamics of MDR and XDR TB, we conducted a DNA fingerprinting analysis of 55 MDR/XDR Mycobacterium tuberculosis strains isolated from TB patients throughout Japan in 2002. Twenty-one (38%) of the strains were classified into 9 clusters with geographic links, which suggests that community transmission of MDR/XDR TB is ongoing. Furthermore, the XDR M. tuberculosis strains were more likely than the non–XDR MDR strains to be clustered (71% vs. 24%; p = 0.003), suggesting that transmission plays a critical role in the new incidence of XDR TB. These findings highlight the difficulty of preventing community transmission of XDR TB by conventional TB control programs and indicate an urgent need for a more appropriate strategy to contain highly developed drug-resistant TB. KW - Mycobacterium tuberculosis KW - molecular epidemiology KW - MDR TB KW - XDR TB KW - RFLP KW - VNTR KW - spoligotyping KW - bacteria KW - tuberculosis and other mycobacteria KW - research KW - Japan DO - 10.3201/eid1606.091844 UR - https://wwwnc.cdc.gov/eid/article/16/6/09-1844_article ER - End of Reference