Distribution and association of Mycobacterium tuberculosis CAS lineage with multidrug resistance in North India

Int J Tuberc Lung Dis. 2016 Jun;20(6):806-11. doi: 10.5588/ijtld.15.0621.

Abstract

Setting: A tertiary care hospital in North India.

Objectives: To determine the prevalence of different genotypes and examine their association with drug resistance among clinical isolates of Mycobacterium tuberculosis from the northern region of India.

Design: We analysed 100 clinical isolates of M. tuberculosis using mycobacterial interspersed repetitive units genotyping and TbD1 analysis.

Results: The analysis revealed that 34% of strains belonged to the Delhi/CAS (TbD1-) lineage, 32% had unknown patterns (27 TbD1-, 5 TbD1+), 18% were of Beijing genotype (TbD1-) and 11% were of EAI lineages (TbD1+). Twenty-one strains were multidrug-resistant tuberculosis (MDR-TB), 9 of which belonged to the Delhi/CAS lineage, 4 were of Beijing lineage, 6 were of unknown pattern and one was of EAI lineage. Our meta-analysis showed the overall proportion of CAS lineage to be 42.96% (95%CI 33-52); the CAS lineage had no association with MDR-TB (OR 0.89, 95%CI 0.66-1.20).

Conclusion: The study highlights the high proportion of CAS lineage strains and absence of association with MDR-TB. The distribution and identification of different genotypes of M. tuberculosis could help in better understanding the factors that influence disease transmission and drug resistance.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / therapeutic use
  • Bacterial Typing Techniques
  • DNA, Bacterial / genetics
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Genetic Loci
  • Genotyping Techniques
  • Humans
  • India / epidemiology
  • Isoniazid / therapeutic use
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / classification
  • Mycobacterium tuberculosis / drug effects
  • Mycobacterium tuberculosis / isolation & purification*
  • Rifampin / therapeutic use
  • Tuberculosis, Multidrug-Resistant / drug therapy
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Young Adult

Substances

  • Antitubercular Agents
  • DNA, Bacterial
  • Isoniazid
  • Rifampin