Beijing Genotype of
            <i>Mycobacterium tuberculosis</i>
            Is Significantly Associated with Human Immunodeficiency Virus Infection and Multidrug Resistance in Cases of Tuberculous Meningitis

Caws, Maxine; Thwaites, Guy; Stepniewska, Kasia; Lan, Nguyễn Thị Ngọc; Duyen, Nguyen Thi Hong; Phuong, Nguyen Thi; Huyen, Mai N. T.; Phan, Minh-Duy; Loc, Tran Huu; Chau, Tran Thi Hong; Soolingen, Dick van; Kremer, Kristin; Châu, Nguyễn Văn Vĩnh; Chinh, Nguyen Tran; Farrar, Jeremy

doi:10.1128/jcm.01181-06

Cited by 76 publications

(52 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Multidrug resistance is a strong independent risk factor for a poor outcome for all forms of tuberculosis (21) and, when strongly linked to mycobacterial genotype, provides a clinically important influence of the bacterial genotype on the outcome. We recently reported a strong association between the Beijing genotype and drug resistance for HIV-infected Vietnamese adults with tuberculous meningitis (5). This study suggests the relationship holds for HIV-uninfected adults with pulmonary disease, and similar findings have been reported from Russia (9) and Kazakhstan (15).…”

Section: Discussionsupporting

confidence: 71%

Relationship between Mycobacterium tuberculosis Genotype and the Clinical Phenotype of Pulmonary and Meningeal Tuberculosis

et al. 2008

Self Cite

View full text Add to dashboard Cite

We used large sequence polymorphisms to determine the genotypes of 397 isolates of Mycobacterium tuberculosis from human immunodeficiency virus-uninfected Vietnamese adults with pulmonary (n ‫؍‬ 235) or meningeal (n ‫؍‬ 162) tuberculosis. We compared the pretreatment radiographic appearances of pulmonary tuberculosis and the presentation, response to treatment, and outcome of tuberculous meningitis between the genotypes. Multivariate analysis identified variables independently associated with genotype and outcome. A higher proportion of adults with pulmonary tuberculosis caused by the Euro-American genotype had consolidation on chest X-ray than was the case with disease caused by other genotypes (P ‫؍‬ 0.006). Multivariate analysis revealed that meningitis caused by the East Asian/Beijing genotype was independently associated with a shorter duration of illness before presentation and fewer cerebrospinal fluid (CSF) leukocytes. Older age, fewer CSF leukocytes, and the presence of hemiplegia (but not strain lineage) were independently associated with death or severe disability, although the East Asian/Beijing genotype was strongly associated with drugresistant tuberculosis. The genotype of M. tuberculosis influenced the presenting features of pulmonary and meningeal tuberculosis. The association between the East Asian/Beijing lineage and disease progression and CSF leukocyte count suggests the lineage may alter the presentation of meningitis by influencing the intracerebral inflammatory response. In addition, increased drug resistance among bacteria of the East Asian/Beijing lineage might influence the response to treatment. This study suggests the genetic diversity of M. tuberculosis has important clinical consequences.

show abstract

Section: Discussionsupporting

confidence: 71%

Relationship between Mycobacterium tuberculosis Genotype and the Clinical Phenotype of Pulmonary and Meningeal Tuberculosis

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…Previous studies have reported that TB caused by the Beijing lineage was associated with multidrug resistance, coinfection with HIV, homelessness, and institutional (e.g., hospital or prison) transmission (11,17,32). To evaluate for Rio patient strain numbers are lightly shaded and boxed; WT LAM patient strain numbers have dark shading; and WT non-LAM patient strain numbers are neither shaded nor boxed.…”

Section: Mtc Pcr Typing Panel Resultsmentioning

confidence: 99%

Discovery of a Novel Mycobacterium tuberculosis Lineage That Is a Major Cause of Tuberculosis in Rio de Janeiro, Brazil

et al. 2007

View full text Add to dashboard Cite

The current study evaluated Mycobacterium tuberculosis isolates from Rio de Janeiro, Brazil, for genomic deletions. One locus in our panel of PCR targets failed to amplify in ϳ30% of strains. A single novel long sequence polymorphism (>26.3 kb) was characterized and designated RD Rio . Homologous recombination between two similar protein-coding genes is proposed as the mechanism for deleting or modifying 10 genes, including two potentially immunogenic PPE proteins. The flanking regions of the RD Rio locus were identical in all strains bearing the deletion. Genetic testing by principal genetic group, spoligotyping, variable-number tandem repeats of mycobacterial interspersed repetitive units (MIRU-VNTR), and IS6110-based restriction fragment length polymorphism analysis cumulatively support the idea that RD Rio strains are derived from a common ancestor belonging solely to the Latin American-Mediterranean spoligotype family. The RD Rio lineage is therefore the predominant clade causing tuberculosis (TB) in Rio de Janeiro and, as indicated by genotypic clustering in MIRU-VNTR analysis, the most significant source of recent transmission. Limited retrospective reviews of bacteriological and patient records showed a lack of association with multidrug resistance or specific risk factors for TB. However, trends in the data did suggest that RD Rio strains may cause a form of TB with a distinct clinical presentation. Overall, the high prevalence of this genotype may be related to enhanced virulence, transmissibility, and/or specific adaptation to a Euro-Latin American host population. The identification of RD Rio strains outside of Brazil points to the ongoing intercontinental dissemination of this important genotype. Further studies are needed to determine the differential strain-specific features, pathobiology, and worldwide prevalence of RD Rio M. tuberculosis.Tuberculosis (TB) is a preventable and curable infectious disease that nonetheless remains a significant cause of morbidity and mortality in resource-poor nations (14). TB also threatens to reemerge in developed nations as a consequence of increased immigration, its synergy with the human immunodeficiency virus (HIV)/AIDS epidemic, and a deprioritization of TB control efforts in public health policy (64). The principal etiologic agent of human TB is Mycobacterium tuberculosis, but other species within the M. tuberculosis complex (MTC), such as "Mycobacterium canettii" (proposed name), Mycobacterium africanum, and Mycobacterium bovis, are also known to cause TB in humans (30). Although the MTC is considered a relatively homogenous taxon at the DNA sequence level, an increasing number of species-, lineage-, and strain-specific genetic variations have been revealed by the identification of multicopy repeat elements, targeted interrogations of specific genetic loci, and the comparison of whole-genome sequences of several MTC species and strains (21,24,31). These differences have been exploited as markers for epidemiological purposes and/or to assist in the identific...

show abstract

“…Within the east Asian lineage, the Beijing genotype has been extensively investigated, as it is widespread and associated with increased virulence. It shows significant association with HIV status, single-and multi-drug resistance [42]. Patients infected with Beijing strain had shorter duration of illness before presentation to hospital and fewer CSF leukocytes, suggesting that mycobacterial genotype may affect disease progression and the intracerebral inflammatory response [43].…”

Section: Immunologymentioning

confidence: 99%

Tuberculous Meningitis in Adults: A Review of a Decade of Developments Focusing on Prognostic Factors for Outcome

2012

Self Cite

View full text Add to dashboard Cite

Tuberculous meningitis (TBM) is the most severe form of TB. Despite treatment, mortality and long-term disability remain unacceptably high. Prevention, early recognition, diagnosis and treatment are fundamental to improving outcomes. However, an effective vaccine remains elusive, initial symptoms are nonspecific, and sensitive diagnostic tests are not available. There has been progress in our understanding of the immunopathology of TBM, and several factors have been found to be associated with susceptibility to infection, disease progression and clinical outcome. However, these have not yet impacted on treatment. Early treatment initiation and uninterrupted continuation, severity on presentation, seizures, stroke, cranial nerve involvement, cerebrospinal fluid cell count and lactate levels, hyponatreamia and coinfection with HIV are all found to be important prognostic factors for outcome. Pathogen lineage (Beijing genotype) and host genetics (polymorphisms in TLR2, TIRAP and LTA4H genes) can influence susceptibility to TBM. However, these findings have not yet impacted on treatment. Progress in vaccine development, opportunities for better diagnostic tests, novel insights into pathogenesis and an increasing evidence base for improving treatment should impact the current high mortality and morbidity, if translated to global and local guidelines.

show abstract

Beijing Genotype of Mycobacterium tuberculosis Is Significantly Associated with Human Immunodeficiency Virus Infection and Multidrug Resistance in Cases of Tuberculous Meningitis

Abstract: Multidrug-resistant tuberculous meningitis is

Cited by 76 publications

References 25 publications

Relationship between Mycobacterium tuberculosis Genotype and the Clinical Phenotype of Pulmonary and Meningeal Tuberculosis

Relationship between Mycobacterium tuberculosis Genotype and the Clinical Phenotype of Pulmonary and Meningeal Tuberculosis

Discovery of a Novel Mycobacterium tuberculosis Lineage That Is a Major Cause of Tuberculosis in Rio de Janeiro, Brazil

Tuberculous Meningitis in Adults: A Review of a Decade of Developments Focusing on Prognostic Factors for Outcome

Contact Info

Product

Resources

About