<i>Mycobacterium tuberculosis</i>Complex Genotype Diversity and Drug Resistance Profiles in a Pediatric Population in Mexico

Parra, Mercedes Macías; Rodrı́guez, Jesús Kumate; García, Jorge Mendoza; López-Vidal, Yolanda; Castañón-Arreola, Mauricio; Balandrano, Susana; Rastogi, Nalin; Castrellón, Pedro Gutiérrez

doi:10.1155/2011/239042

Cited by 11 publications

(15 citation statements)

References 27 publications

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“…In Mexico City, SIT53 has been reported to be the predominant subtype in patients with immunodeficiency (5) and in multidrug-resistant (MDR) isolates (4). In HIV patients and in pediatric patients (5,6), the LAM9 family spoligotype SIT42 predominates, and SIT53 is the next most common spoligotype. Beyond Mexico City, SIT53 is quite predominant throughout the country; depending on the region, either SIT42 or SIT119 is the second most dominant subtype.…”

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confidence: 99%

Comparative Mycobacterium tuberculosis Spoligotype Distribution in Mexico

et al. 2014

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In the present work, we studied the genetic diversity of Mycobacterium tuberculosis clinical isolates from patients according to their gender, age, and geographic location in Mexico. We did not observe any statistically significant differences in regard to age or gender. We found that spoligo international type 53 (SIT53) is more frequent in the northern states and that SIT119 predominates in central Mexico. In a previous work, we described the spoligotype distribution in Nuevo León, Mexico, and reported that spoligo international type 53 (SIT53) and SIT119 were the most common spoligotypes to be isolated (representing ϳ39% of the total sample) (1). We also reported the tendencies of SIT53 to be isolated more frequently in elderly patients and of SIT119 to be isolated more frequently in younger patients (Ͻ20 years old). However, our sample size was too small to definitively support this conclusion. In the present work, we used a larger population sample to determine whether this difference is genuine and compared the distribution of spoligotypes in Nuevo León against those of the oldest and most densely populated region of Mexico, Mexico City, which has a population of ϳ30 million people.M. tuberculosis isolates (n ϭ 414) were obtained from the laboratories of either the Laboratorio Estatal de Salud Pública or the tuberculosis clinic at the Hospital Universitario, Dr. José E. Gonzalez UANL, Monterrey, Mexico, from 2001 to 2012. Because we observed a relationship between the distribution of spoligotypes and patient gender and age in a previous study, we included 233 new samples from Nuevo León; 116 cases were from patients 0 to 20 years old, and 117 cases were from patients Ͼ50 years old. From the Instituto Nacional de Enfermedades Respiratorias (INER) in Mexico City, we obtained 181 isolates from patients from several of Mexico's states, including Distrito Federal (n ϭ 126), Chiapas (n ϭ 10), Oaxaca (n ϭ 11), Veracruz (n ϭ 24), San Luis Potosí (n ϭ 1), Jalisco (n ϭ 1), and Michoacán (n ϭ 8).Isolates were obtained from any tuberculosis patient in the population and were grown on Lowenstein-Jensen medium. DNA isolation was performed using the method of van Embden et al. (2). Spoligotyping was accomplished using a standard technique as described previously (3).The spoligotypes were entered into the SITVIT2 database (Pasteur Institute of Guadeloupe) in a binary format. This database is an updated version of the previously released SpolDB4 database (see http://www.pasteur-guadeloupe.fr:8081/SITVIT_ONLINE).To establish differences in the spoligotype distribution among patients of different ages and genders, 233 samples corresponding to individuals who were either Ͻ30 or Ͼ60 years of age were analyzed. We observed a difference of 33% for SIT119 over SIT53 in the male patients, although this difference was not statistically significant. In the groups divided by age, we observed a 33% increase in the number of SIT119 spoligotypes in the younger patients; however, no significant differences were observed (Table 1). Final...

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Comparative Mycobacterium tuberculosis Spoligotype Distribution in Mexico

et al. 2014

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“…Cheese consumption has been associated with cases of intestinal tuberculosis in Mexican children residing in New York City, and a similar situation was identified in Denver, Colorado, where most cases of tuberculosis caused by M. bovis occurred in Mexican residents [3, 4]. In a recent study in the vicinity of Mexico City, 13.8% of samples from symptomatic individuals with the tuberculosis complex corresponded by spoligotyping to M. bovis [2]. …”

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confidence: 81%

“…Notable differences between primary and secondary intestinal tuberculosis can be summarized as follows. M. bovis was the most frequent etiologic agent in primary intestinal tuberculosis and exclusive to this form, which indicates that the ingestion of milk from diseased cows is the main pathogenic mechanism [2, 5]. The secondary form, on the other hand, may result from hematogenous seeding or from the ingestion of contaminated material from pulmonary lesions in patients infected with M. tuberculosis [18].…”

Section: Discussionmentioning

confidence: 99%

“…The incidence in 2007 was 13.49 cases/100 000 individuals and 5.077/100 000 in children under the age of 19 [1]. Around 16% of dairy cattle are infected with M. bovis, and 30% to 50% of their product is sold as nonpasteurized milk or cheese with a wide distribution [2]. Cheese consumption has been associated with cases of intestinal tuberculosis in Mexican children residing in New York City, and a similar situation was identified in Denver, Colorado, where most cases of tuberculosis caused by M. bovis occurred in Mexican residents [3, 4].…”

Section: Introductionmentioning

confidence: 99%

“…This distinction is important because it gives rise to different diagnostic approaches and epidemiological and preventive actions, particularly in countries where tuberculosis is endemic and infection by M. bovis continues to be identified. Infection by M. bovis requires intervention at the level of agricultural and food handling services to disrupt transmission to humans, whereas M. tuberculosis infection demands strengthening of public health measures to contain human-to-human spread [2]. …”

Section: Introductionmentioning

confidence: 99%

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Intestinal/Peritoneal Tuberculosis in Children: An Analysis of Autopsy Cases

Ridaura‐Sanz¹,

López-Corella²,

López‐Ridaura³

2012

Tuberculosis Research and Treatment

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Infection by Mycobacterium bovis is not infrequently identified in Mexico. Its relation to nonpasteurized milk products ingestion is well recognized with primary infection usually in the intestinal tract. The term “abdominal tuberculosis” includes peritoneal as well as primary and secondary intestinal tuberculosis. The clinical differentiation of these conditions is difficult. In this work, we reviewed the clinical and pathological features of 24 cases of children dying with tuberculosis in whom autopsy revealed abdominal disease in a referral hospital in Mexico City. We identified 8 cases of primary intestinal tuberculosis, with documentation of M. bovis in 6 of them, and 9 cases of secondary intestinal tuberculosis (primary pulmonary disease), all negative to M. bovis. Seven patients had peritoneal tuberculosis without intestinal lesions and with active pulmonary disease in 4 of them, and of the remaining three, two had mesenteric lymph node involvement suggesting healed intestinal disease. In this approach to abdominal tuberculosis, postmortem analysis was able to differentiate primary from secondary intestinal tuberculosis and to define the nature of peritoneal involvement. This discrimination gives rise to different diagnostic approaches and epidemiological and preventive actions, particularly in countries where tuberculosis is endemic and infection by M. bovis continues to be identified.

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