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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.

Main Article

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Page created: February 12, 2013
Page updated: February 12, 2013
Page reviewed: February 12, 2013
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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