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Journal of Clinical Microbiology, November 2006, p. 3934-3939, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.01181-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Beijing Genotype of Mycobacterium tuberculosis Is Significantly Associated with Human Immunodeficiency Virus Infection and Multidrug Resistance in Cases of Tuberculous Meningitis{triangledown}

Maxine Caws,1,5* Guy Thwaites,2 Kasia Stepniewska,4,5 Nguyen Thi Ngoc Lan,3 Nguyen Thi Hong Duyen,1 Nguyen Thi Phuong,1 Mai Nguyet Thu Huyen,3 Phan Minh Duy,1 Tran Huu Loc,3 Tran Thi Hong Chau,6 Dick van Soolingen,7 Kristin Kremer,7 Nguyen Van Vinh Chau,4 Nguyen Tran Chinh,6 and Jeremy Farrar1,5

Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, Quan 5, Ho Chi Minh City, Vietnam,1 Brighton and Sussex University Hospital, Department of Infectious Diseases and Microbiology, Eastern Road, Brighton, Sussex, BN2 5BE, United Kingdom,2 Pham Ngoc Thach Hospital for Tuberculosis and Lung Diseases, Huong Vuong, District 5, Ho Chi Minh City, Vietnam,3 Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand,4 Centre for Clinical Vaccinology and Tropical Medicine, Churchill Hospital, Old Road, Headington, Oxford, United Kingdom,5 The Hospital for Tropical Diseases, Ho Chi Minh City, Viet Nam,6 Tuberculosis Reference Laboratory, National Institute for Public Health, Antonie van Leeuwenhoeklaan 9, Bilthoeven, 3721 BA, The Netherlands7

Received 8 June 2006/ Returned for modification 12 July 2006/ Accepted 16 August 2006

Multidrug-resistant tuberculous meningitis is fatal without rapid diagnosis and use of second-line therapy. It is more common in human immunodeficiency virus (HIV)-positive patients. Beijing genotype strains of Mycobacterium tuberculosis are associated with drug resistance, particularly multidrug resistance, and their prevalence is increasing worldwide. The prevalence of Beijing genotype strains among Mycobacterium tuberculosis isolates from the cerebrospinal fluid of HIV-positive (n = 35) and HIV-negative (n = 187) patients in Ho Chi Minh City was determined. The Beijing genotype was significantly associated with HIV status (odds ratio [OR] = 2.95 [95% confidence interval {CI}, 1.38 to 6.44]; P = 0.016), resistance to any drug (OR = 3.34 [95% CI, 1.87 to 5.95]; P < 0.001) and multidrug resistance (Fisher's exact test; P = 0.001). The association of the Beijing genotype with drug resistance was independent of HIV status. This is the first report of Beijing genotype association with HIV status, which may be an association unique to tuberculous meningitis.

* Corresponding author. Mailing address: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, Quan 5, Ho Chi Minh City, Vietnam. Phone: (84 8) 8384013. Fax: (84 8) 8353904. E-mail: mcaws{at}hotmail.com.

{triangledown} Published ahead of print on 13 September 2006.

Journal of Clinical Microbiology, November 2006, p. 3934-3939, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.01181-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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