Context Tuberculosis and multidrug-resistant tuberculosis is a serious public health problem in Russia.Objective To address the extent of "Beijing strain" transmission in the prison/civil sectors and the association of drug resistance, clinical, and social factors with the Beijing genotype.
Design and SettingCross-sectional population-based molecular epidemiological study of all civilian and penitentiary tuberculosis facilities in the Samara region, Russia.
Patients Consecutively recruited patients with bacteriologically proven tuberculosis (n = 880).Main Outcome Measure Proportion of Beijing strains and association with drug resistance, human immunodeficiency virus infection, imprisonment, radiological, clinical, and other social factors.
ResultsBeijing-family strains (identified by spoligotyping and composed of 2 main types by mycobacterial interspersed repetitive unit analysis) were predominant: 586/880 (66.6%; 95% confidence interval [CI], 63.4%-69.7%) with a significantly higher prevalence in the prison population (rate ratio [RR], 1.3; 95% CI, 1.2-1.5) and those aged younger than 35 years (RR, 1.2; 95% CI, 1.0-1.3). Comparable proportions were coinfected with the human immunodeficiency virus (Ϸ10%), concurrent hepatitis B and C (21.6%), drank alcohol (Ϸ90%), smoked (Ϸ90%), and had a similar sexual history. Drug resistance was nearly 2-fold higher in patients infected with Beijing strains compared with non-Beijing strains: