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Journal of Clinical Microbiology, June 2002, p. 1930-1937, Vol. 40, No. 6
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.6.1930-1937.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Spread of Drug-Resistant Mycobacterium tuberculosis Strains of the Beijing Genotype in the Archangel Oblast, Russia

Olga S. Toungoussova,1,2 Per Sandven,1 Andrey O. Mariandyshev,3 Nina I. Nizovtseva,4 Gunnar Bjune,2 and Dominique A. Caugant1*

Division of Infectious Disease Control, Norwegian Institute of Public Health,1 Department of International Health, Faculty of Medicine, University of Oslo, Oslo, Norway,2 Department of Phthysiopulmonology, Northern State Medical University,3 Archangel Regional Tuberculosis Dispensary, Archangel Oblast, Russia4

Received 18 December 2001/ Returned for modification 16 February 2002/ Accepted 6 March 2002

A collection of 119 strains of Mycobacterium tuberculosis isolated from patients with pulmonary tuberculosis in the Archangel Oblast, Russia, in 1998 and 1999 were studied by using restriction fragment length polymorphism (RFLP) analysis with the IS6110 probe and spoligotyping. Resistance of the strains to antituberculosis drugs was analyzed by the BACTEC method, and mutations associated with rifampin resistance were detected by using the Inno-LiPA Rif. TB test. RFLP analysis and spoligotyping demonstrated that 53 (44.5%) of the strains belonged to the Beijing genotype. These strains showed a significantly higher rate of resistance than M. tuberculosis strains of other genotypes circulating in the region. In particular, 43.4% of the strains of the Beijing genotype were multidrug resistant; in contrast, only 10.6% of the other strains were. Of the strains of the Beijing genotype, 92.5% were part of a cluster, while only 33.3% of the remaining strains were clustered. Analysis of the medical records of the patients demonstrated that individuals infected with a strain of the Beijing genotype were significantly more likely to be alcohol abusers and to have chronic obstructive pulmonary disease prior to the tuberculosis diagnosis. Multivariate analysis showed that both variables were independently associated with infection by strains belonging to the Beijing genotype. Our study demonstrated that strains of the Beijing genotype are an important cause of tuberculosis in the Archangel Oblast and that dissemination of these strains is associated with the high incidence of drug resistance.

* Corresponding author. Mailing address: Division of Infectious Disease Control, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, N-0403 Oslo, Norway. Phone: (47) 22 04 23 11. Fax: (47) 22 04 25 18. E-mail: dominique.caugant{at}folkehelsa.no.

Journal of Clinical Microbiology, June 2002, p. 1930-1937, Vol. 40, No. 6
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.6.1930-1937.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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