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Journal of Clinical Microbiology, September 2001, p. 3339-3345, Vol. 39, No. 9
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.9.3339-3345.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Spread of Drug-Resistant Pulmonary Tuberculosis in Estonia

Annika Krüüner,1,2 Sven E. Hoffner,3 Heinart Sillastu,4 Manfred Danilovits,4 Klavdia Levina,5 Stefan B. Svenson,3,6 Solomon Ghebremichael,2 Tuija Koivula,2,3 and Gunilla Källenius2,3,*

Institute of Microbiology, Tartu University,1 and Tartu University Lung Hospital, Clinicum,4 Tartu, and Kivimäe Hospital, Tallinn,5 Estonia, and Microbiology and Tumor Biology Center, Karolinska Institute,2 and Swedish Institute for Infectious Disease Control,3 Stockholm, and Department of Bacteriology, Biomedicum, Swedish University for Agricultural Sciences, Uppsala,6 Sweden

Received 27 February 2001/Returned for modification 16 April 2001/Accepted 15 June 2001

Restriction fragment length polymorphism (RFLP) analysis of 209 Mycobacterium tuberculosis clinical isolates obtained from newly detected pulmonary tuberculosis patients (151 male and 58 female; mean age, 41 years) in Estonia during 1994 showed that 61 isolates (29%) belonged to a genetically closely related group of isolates, family A, with a predominant IS6110 banding pattern. These strains shared the majority of their IS6110 DNA-containing restriction fragments, representing a predominant banding pattern (similarity, >65%). This family A comprised 12 clusters of identical isolates, and the largest cluster comprised 10 strains. The majority (87.5%) of all multidrug-resistant (MDR) isolates, 67.2% of all isolates with any drug resistance, but only 12% of the fully susceptible isolates of M. tuberculosis belonged to family A. These strains were confirmed by spoligotyping as members of the Beijing genotype family. The spread of Beijing genotype MDR M. tuberculosis strains was also frequently seen in 1997 to 1999. The members of this homogenous group of drug-resistant M. tuberculosis strains have contributed substantially to the continual emergence of drug-resistant tuberculosis all over Estonia.

* Corresponding author. Mailing address: Swedish Institute for Infectious Disease Control, Nobels Vag 18, SE-171 82 Solna, Stockholm, Sweden. Phone: 46 8 4572430. Fax: 46 8 301797. E-mail: gunilla.kallenius{at}smi.ki.se.

Journal of Clinical Microbiology, September 2001, p. 3339-3345, Vol. 39, No. 9
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.9.3339-3345.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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