A Snapshot of Drug-Resistant M. tuberculosis Strains in Croatia
Tuberculosis caused by resistant M. tuberculosis strains poses a serious threat as it requires prolonged and costly treatment and has high mortality rate. In order to investigate resistance to antituberculous drugs in Croatia, we analysed all resistant M. tuberculosis strains isolated from patients’ samples in period 2010–2014 (1 strain per patient). Out of 2384 M. tuberculosis strains, we identified 88 (3.69 %) resistant strains. The analysis included resistance patterns, resistance conferring mutations and, according to MIRU-VNTR analysis, clustering and global lineages distribution. Relatively high number of strains was monoresistant, especially to isoniazid, while there were only six multiresistant strains. Among 59 strains with any pattern that includes resistance to isoniazid, a total of 22 (37.29 %) had resistance conferring mutation in katG gene (S315T), 23 (38.98 %) in inhA promoter region (C-15T) and 14 (23.73 %) had none of these mutations. The observed clustering rate of resistant strains was 28.41 %, and the most common global lineage was Euro-American (75 %).
KeywordsResistant tuberculosis Isoniazid resistance Resistance conferring mutations Clustering rate Global lineages
- Allix-Béguec C, Harmsen D, Weniger T, Supply P, Niemann S (2008) Evaluation and user-strategy of MIRU-VNTR plus, a multifunctional database for online analysis of genotyping data and phylogenetic identification of Mycobacterium tuberculosis complex isolates. J Clin Microbiol 46:2692–2699CrossRefPubMedPubMedCentralGoogle Scholar
- Croatian Health Service Yearbook 2014 (2015) Croatian National Institute of Public Health, Zagreb, p 190Google Scholar
- European Centre for Disease Prevention and Control/WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2015, p 77Google Scholar
- Supply P, Allix C, Lesjean S, Oelemann MC, Rűsch-Gerdes S, Willery E et al (2006) Proposal for standardization of optimized mycobacterial interspersed repetitive unit – variable-number tandem repeat typing of Mycobacterium tuberculosis. J Clin Microbiol 44:4498–4510CrossRefPubMedPubMedCentralGoogle Scholar
- van Soolingen D, de Haas PEW, van Doorn HR, Kuijper E, Rinder H, Borgdorff MW (2000) Mutations at amino acid position 315 of the katG gene are associated with high-level resistance to isoniazid, other drug resistance, and successful transmission of Mycobacterium tuberculosis in The Netherlands. J Infect Dis 182:1788–1790CrossRefPubMedGoogle Scholar