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Journal of Clinical Microbiology, March 2005, p. 1220-1227, Vol. 43, No. 3
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.3.1220-1227.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Systematic Molecular Characterization of Multidrug-Resistant Mycobacterium tuberculosis Complex Isolates from Spain

S. Samper,^1* M. J. Iglesias,² M. J. Rabanaque,² L. I. Gómez,² M. C. Lafoz,³ M. S. Jiménez,⁴ A. Ortega,⁵ M. A Lezcano,¹ D. Van Soolingen,⁶ C. Martín,³ and The Spanish Working Group on MDR-TB

Servicio de Microbiología, Hospital Universitario Miguel Servet,¹ Departamento de Microbiología, Medicina Preventiva y Salud Pública,² Laboratory of Micobacterial Genetics, University of Zaragoza, Zaragoza,³ Mycobacterial Reference Laboratory, Servicio de Bacteriología, Centro Nacional de Microbiología,⁴ Hospital Carlos III, Instituto de Salud Carlos III, Madrid, Spain,⁵ National Institute of Public Health and the Environment, Bilthoven, The Netherlands⁶

Received 23 July 2004/ Returned for modification 24 September 2004/ Accepted 13 November 2004

We used spoligotyping and restriction fragment length polymorphism (RFLP) of the IS6110-insertion sequence to study the molecular epidemiology of multidrug-resistant (MDR) tuberculosis in Spain. We analyzed 180 Mycobacterium tuberculosis complex isolates collected between January 1998 and December 2000. Consecutive isolates from the same patients (n = 23) always had identical genotypes, meaning that no cases of reinfection occurred. A total of 105 isolates (58.3%) had unique RFLP patterns, whereas 75 isolates (41.7%) were in 20 different RFLP clusters. Characterization of the katG and rpoB genes showed that 14 strains included in the RFLP clusters did not actually cluster. Only 33.8% of the strains isolated were suggestive of MDR transmission, a frequency lower than that for susceptible strains in Spain (46.6%). We found that the Beijing/W genotype, which is prevalent worldwide, was significantly associated with immigrants. The 22 isolates in the largest cluster corresponded to the Mycobacterium bovis strain responsible for two nosocomial MDR outbreaks in Spain.

Contributing members of The Spanish Working Group on MDR-TB are listed in Acknowledgments.

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