Emergence and spread of extensively and totally drug-resistant tuberculosis, South Africa

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dc.contributor.authorKlopper, Marisaen_ZA
dc.contributor.authorWarren, Robin Marken_ZA
dc.contributor.authorHayes, Cindyen_ZA
dc.contributor.authorGey van Pittius, Nicolaas Claudiusen_ZA
dc.contributor.authorStreicher, Elizabeth M.en_ZA
dc.contributor.authorMuller, Bornaen_ZA
dc.contributor.authorSirgel, Frederick Adriaanen_ZA
dc.contributor.authorChabula-Nxiweni, Mamisaen_ZA
dc.contributor.authorHoosain, Ebrahimen_ZA
dc.contributor.authorCoetzee, Gerriten_ZA
dc.contributor.authorVan Helden, Paul Daviden_ZA
dc.contributor.authorVictor, Thomas Calldoen_ZA
dc.contributor.authorTrollip, Andre Phillipen_ZA
dc.date.accessioned2014-07-07T12:18:24Z
dc.date.available2014-07-07T12:18:24Z
dc.date.issued2013-03
dc.descriptionCITATION: Klopper, M. et al. 2013. Emergence and spread of extensively and totally drug-resistant tuberculosis, South Africa. Emerging Infectious Diseases, 19(3):449-455, doi:10.3201/eid1903.120246.
dc.descriptionThe original publication is available at http://wwwnc.cdc.gov/eid
dc.description.abstractENGLISH ABSTRACT: Factors driving the increase in drug-resistant tuberculosis (TB) in the Eastern Cape Province, South Africa, are not understood. A convenience sample of 309 drug-susceptible and 342 multidrug-resistant (MDR) TB isolates, collected July 2008–July 2009, were characterized by spoligotyping, DNA fingerprinting, insertion site mapping, and targeted DNA sequencing. Analysis of molecular-based data showed diverse genetic backgrounds among drug-sensitive and MDR TB sensu stricto isolates in contrast to restricted genetic backgrounds among pre–extensively drug-resistant (pre-XDR) TB and XDR TB isolates. Second-line drug resistance was significantly associated with the atypical Beijing genotype. DNA fingerprinting and sequencing demonstrated that the pre-XDR and XDR atypical Beijing isolates evolved from a common progenitor; 85% and 92%, respectively, were clustered, indicating transmission. Ninety-three percent of atypical XDR Beijing isolates had mutations that confer resistance to 10 anti-TB drugs, and some isolates also were resistant to para-aminosalicylic acid. These findings suggest the emergence of totally drug-resistant TB.en_ZA
dc.description.urihttp://wwwnc.cdc.gov/eid/article/19/3/12-0246_article
dc.description.versionPublisher's version
dc.format.extent7 pages : mapen_ZA
dc.identifier.citationKlopper, M. et al. 2013. Emergence and spread of extensively and totally drug-resistant tuberculosis, South Africa. Emerging Infectious Diseases, 19(3):449-455, doi:10.3201/eid1903.120246.
dc.identifier.issn1080-6059 (online)
dc.identifier.otherdoi:10.3201/eid1903.120246
dc.identifier.urihttp://hdl.handle.net/10019.1/93343
dc.language.isoen_ZAen_ZA
dc.publisherCenters for Disease Control and Preventionen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectTuberculosis -- South Africaen_ZA
dc.subjectDrug resistant tuberculosisen_ZA
dc.subjectMDR-TB (Multidrug-resistant tuberculosis)en_ZA
dc.titleEmergence and spread of extensively and totally drug-resistant tuberculosis, South Africaen_ZA
dc.typeArticleen_ZA
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