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Journal of Clinical Microbiology, April 1999, p. 998-1003, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Molecular Evidence for Heterogeneity of the Multiple-Drug-Resistant Mycobacterium tuberculosis Population in Scotland (1990 to 1997)

Z. Fang,1,dagger C. Doig,2 A. Rayner,2 D. T. Kenna,1 B. Watt,2 and K. J. Forbes1,*

Medical Microbiology, Aberdeen University, Foresterhill, Aberdeen, AB25 2ZD,1 and Scottish Mycobacteria Reference Laboratory, The City Hospital, Edinburgh, EH10 5SB,2 United Kingdom

Received 1 October 1998/Returned for modification 6 November 1998/Accepted 30 December 1998

Multiple-drug-resistant Mycobacterium tuberculosis (MDR-MTB) has been well studied in hospitals or health care institutions and in human immunodeficiency virus-infected populations. However, the characteristics of MDR-MTB in the community have not been well investigated. An understanding of its prevalence and circulation within the community will help to estimate the problem and optimize the strategies for control and prevention of its development and transmission. In this study, MDR-MTB isolates from Scotland collected between 1990 and 1997 were characterized, along with non-drug-resistant isolates. The results showed that they were genetically diverse, suggesting they were unrelated to each other and had probably evolved independently. Several new alleles of rpoB, katG, and ahpC were identified: rpoB codon 525 (ACCright-arrowAAC; Thr525Asn); katG codon 128 (CGGright-arrowCAG; Arg128Gln) and codon 291 (GCTright-arrowCCT; Ala291Pro); and the ahpC synonymous substitution at codon 6 (ATTright-arrowATC). One of the MDR-MTB isolates from an Asian patient had an IS6110 restriction fragment length polymorphism pattern very similar to that of the MDR-MTB W strain and had the same drug resistance-related alleles but did not have any epidemiological connection with the W strains. Additionally, a cluster of M. tuberculosis isolates was identified in our collection of 715 clinical isolates; the isolates in this cluster had genetic backgrounds very similar to those of the W strains, one of which had already developed multiple drug resistances. The diverse population of MDR-MTB in Scotland, along with a low incidence of drug-resistant M. tuberculosis, has implications for the control of the organism and prevention of its spread.

* Corresponding author. Mailing address: Medical Microbiology, Aberdeen University, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom. Phone: 44 1224 663123, ext. 54953. Fax: 44 1224 685604. E-mail: mmb001{at}abdn.ac.uk.

dagger Present address: Dept. of Biomedical Sciences, University of Bradford, West Yorkshire, BD7 1DP, United Kingdom.

Journal of Clinical Microbiology, April 1999, p. 998-1003, Vol. 37, No. 4
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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