Molecular Diversity of Drug Resistant Mycobacterium Tuberculosis Strains in Western Turkey

Abstract

Objective: The aim of this study was to investigate the molecular diversity and clonal relationship of drug resistant Mycobacterium tuberculosis strains isolated in Western Turkey. Materials and Methods: A total of 87 strains isolated between 2006 and 2009, eight of which were rifampicin monoresistant and 79 were multidrug resistant, were analyzed with IS6110 RFLP and spoligotyping methods. Results: The results of spoligotyping showed that 7% of the strains were orphans, and 8% were undefined for family in the SpolDB4 database. Major families of the strains were LAM (38%), T (35%), Haarlem (7%), Beijing (2%), S (2%) and U (1%) families. The clustering rate by spoligotyping was calculated as 75%. The most predominant SIT cluster was SIT41 (29%). According to the results of IS6110 RFLP, 71 different patterns of IS6110 were observed. Low copy number was found in 26% of the strains. When the results of two methods were combined, the final clustering rate was calculated as 26%. Conclusions: The genotypical distribution of drug resistant tuberculosis isolates in our region indicates genetic diversity and the clustering rate was found low in our region. However, more comprehensive and long-term molecular epidemiological studies are needed to control the drug resistant strains. Turkish Başlık: Türkiye'nin Batısında İzole Edilen İlaca Dirençli Mycobacterium tuberculosis Kökenlerinin Moleküler Çeşitliliği Anahtar Kelimeler: Mycobacterium tuberculosis, ilaç direnci, genotipleme, epidemiyoloji Amaç: Bu çalışmanın amacı Türkiye'nin Batısında izole edilen ilaca dirençli Mycobacterium tuberculosis kökenlerinin moleküler çeşitliliğini ve klonal ilişkisini araştırmaktır. Gereç ve Yöntem: 2006-2009 yılları arasında izole edilen sekizi rifampisine tek ilaç dirençli, 79'u çok ilaca dirençli olmak üzere toplam 87 köken IS6110 RFLP ve spoligotiplendirme yöntemleri ile incelenmiştir. Bulgular: Spoligotiplendirme sonuçlarına göre kökenlerin %7'si öksüz olarak tanımlanmış, %8'i ise SpoIDB4 veri tabanına göre tanımlanamayan ailelere ait bulunmuştur. Kökenlerin ait olduğu aileler LAM (%38), T (%35), Harlem (%7), Beijing (%2), S (%2) ve U (%1) olarak belirlenmiştir. Spoligotiplendirme sonuçlarına göre kümelenme oranı %75 olarak hesaplanmıştır. En baskın (%29) SIT kümesi SIT41'dir. IS6110 RFLP sonuçlarına göre 71 farklı IS6110 kalıbı izlenmiştir. Kökenlerin %26'sında kopya sayısı düşük bulunmuştur. Her iki yöntemin sonuçları birlikte değerlendirildiğinde kümelenme oranı %26 olarak bulunmuştur. Sonuçlar: Bölgemizde izole edilen ilaca dirençli tüberküloz basili kökenlerinin genotipik dağılımı çeşitlilik göstermektedir ve bölgemizde kümelenme oranı düşük bulunmuştur. Ancak ilaca dirençli kökenlerin kontrolü için daha kapsamlı ve uzun süren moleküler epidemiyolojik araştırmalara gereksinim vardır.

Keywords

• Mycobacterium tuberculosis, drug resistance, genotyping, epidemiology

Molecular Diversity of Drug Resistant Mycobacterium Tuberculosis Strains in Western Turkey

Öz

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