This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow An erratum has been published
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Phyu, S.
Right arrow Articles by Grewal, H. M. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Phyu, S.
Right arrow Articles by Grewal, H. M. S.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, February 2009, p. 335-344, Vol. 47, No. 2
0095-1137/09/$08.00+0     doi:10.1128/JCM.01812-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Predominance of Mycobacterium tuberculosis EAI and Beijing Lineages in Yangon, Myanmar {triangledown}

Sabai Phyu ,1,{dagger},{ddagger} Ruth Stavrum,1,2,{ddagger} Thandar Lwin,3 Øyvind S. Svendsen,2 Ti Ti,3 and Harleen M. S. Grewal1,2*

The Gade Institute, Section for Microbiology and Immunology, University of Bergen, Bergen, Norway,1 Department of Microbiology and Immunology, Haukeland University Hospital, Bergen, Norway,2 National TB Control Program, Yangon, Myanmar3

Received 19 September 2008/ Returned for modification 30 October 2008/ Accepted 18 November 2008

Isolates of the Mycobacterium tuberculosis Beijing lineage are associated with high rates of transmission, hypervirulence and drug resistance. The Beijing lineage has been shown to dominate the tuberculosis (TB) epidemic in East Asia; however, the diversity and frequency of M. tuberculosis genotypes from Myanmar are unknown. We present the first comprehensive study describing the M. tuberculosis isolates circulating in Yangon, Myanmar. Thus, 310 isolates from pulmonary TB patients from Yangon, Myanmar, were genotyped by spoligotyping and IS6110-based restriction fragment length polymorphism analysis (IS6110 RFLP). The most frequent lineages observed were the East African-Indian (EAI; 48.4%; n = 150) and Beijing (31.9%; n = 99) lineages. Isolates belonging to the most frequent shared types (STs), ST1 (n = 98; Beijing), ST292 (n = 28; EAI), and ST89 (n = 11; EAI), had ≥75% similarity in their IS6110 patterns. Five of 11 Beijing isolates comprising five clusters with identical IS6110 RFLP patterns could be discriminated by mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) analysis. Of the 150 EAI isolates, 40 isolates (26.7%) had only one IS6110 copy, and 17 of these isolates could be discriminated by MIRU-VNTR analysis. The findings from this study suggest that although there is a predominance of the ancient EAI lineage in Yangon, the TB epidemic in Yangon is driven by clonal expansion of the ST1 genotype. The Beijing lineage isolates (21.4%) were more likely (P = 0.009) than EAI lineage isolates to be multidrug resistant (MDR) (1.3%; odds ratio, 3.2, adjusted for the patients' history of exposure to anti-TB drugs), suggesting that the spread of MDR Beijing isolates is a major problem in Yangon.

* Corresponding author. Mailing address: Section for Microbiology and Immunology, The Gade Institute, University of Bergen and Haukeland University Hospital, Bergen N-5021, Norway. Phone: 47-55974631. Fax: 47-55974689. E-mail: Harleen.Grewal{at}Gades.uib.no

{triangledown} Published ahead of print on 26 November 2008.

{dagger} Present address: Novartis Institute for Tropical Diseases, 10 Biopolis Road #05-01 Chromos Building, Singapore 138670, Singapore.

{ddagger} Both of these authors contributed equally to this study.

Journal of Clinical Microbiology, February 2009, p. 335-344, Vol. 47, No. 2
0095-1137/09/$08.00+0     doi:10.1128/JCM.01812-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Valvatne, H., Syre, H., Kross, M., Stavrum, R., Ti, T., Phyu, S., Grewal, H. M. S. (2009). Isoniazid and rifampicin resistance-associated mutations in Mycobacterium tuberculosis isolates from Yangon, Myanmar: implications for rapid molecular testing. J Antimicrob Chemother 64: 694-701 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»