Emerging Infectious Diseases (Mar 2020)

Multidrug- and Extensively Drug-Resistant Mycobacterium tuberculosis Beijing Clades, Ukraine, 2015

  • Matthias Merker,
  • Elena Nikolaevskaya,
  • Thomas A. Kohl,
  • Barbara Molina-Moya,
  • Olha Pavlovska,
  • Patrik Brännberg,
  • Andrii Dudnyk,
  • Valentyna Stokich,
  • Ivan Barilar,
  • Iryna Marynova,
  • Tetiana Filipova,
  • Cristina Prat,
  • Anders Sjöstedt,
  • Jose Dominguez,
  • Olena Rzhepishevska,
  • Stefan Niemann

DOI
https://doi.org/10.3201/eid2603.190525
Journal volume & issue
Vol. 26, no. 3
pp. 481 – 490

Abstract

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Multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB) is an emerging threat to TB control in Ukraine, a country with the third highest XDR TB burden globally. We used whole-genome sequencing of a convenience sample to identify bacterial genetic and patient-related factors associated with MDR/XDR TB in this country. MDR/XDR TB was associated with 3 distinct Mycobacterium tuberculosis complex lineage 2 (Beijing) clades, Europe/Russia W148 outbreak, Central Asia outbreak, and Ukraine outbreak, which comprised 68.9% of all MDR/XDR TB strains from southern Ukraine. MDR/XDR TB was also associated with previous treatment for TB and urban residence. The circulation of Beijing outbreak strains harboring broad drug resistance, coupled with constraints in drug supply and limited availability of phenotypic drug susceptibility testing, needs to be considered when new TB management strategies are implemented in Ukraine.

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