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PCR-Based Methodology for Detecting Multidrug-Resistant Strains of Mycobacterium tuberculosis Beijing Family Circulating in Russia

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Abstract

The Beijing genotype of Mycobacterium tuberculosis has been identified in 40–50% of the clinical isolates studied in Russia during the last decade. This genotype has been reported to be associated with multiple drug resistance and possesses some significant pathogenic properties. Therefore, early identification of such strains is of extreme importance in the timely detection of drug resistance. The present study was performed on 354 strains isolated in Russia from 1996 to 2002 and previously characterised by IS6110-restriction fragment length polymorphism (RFLP) typing and spoligotyping. These strains included 198 Beijing family strains and 156 strains of other genotypes (IS6110-RFLP profiles). A subsequent polymerase chain reaction (PCR) analysis with IS6110-derived outwardly oriented primers (IS6110-PCR) easily discriminated the Beijing strains from non-Beijing strains. The multiplex allele-specific (MAS)-PCR assays were further used to detect mutations in katG315 and rpoB531, associated with resistance to isoniazid and rifampin, respectively. The katG315 and rpoB531 mutations were found to be more prevalent among Beijing (96.8% and 77.3%) than among non-Beijing strains (85.7% and 28%). Consequently, we propose a two-step methodology based on routine PCR and simple agarose gel electrophoresis in order to detect (i) a Beijing family strain using IS6110-PCR, and, (ii) its possible resistance to the major anti-tuberculosis drugs using specific MAS-PCR assays.

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References

  1. Sreevatsan S, Pan X, Stockbauer K, Connell N, Kreiswirth B, Whittam T, Musser JM (1997) Restricted structural gene polymorphism in the Mycobacterium tuberculosis complex indicates evolutionary recent global dissemination. Proc Natl Acad Sci USA 97:9869–9874

    Article  Google Scholar 

  2. Embden JDA van, Gorkom T van, Kremer K, Jansen T, der Zeijst BAM van, Schouls LM (2000) Genetic variation and evolutionary origin of the direct repeat locus of Mycobacterium tuberculosis complex bacteria. J Bacteriol 182:2393–2401

    Article  PubMed  Google Scholar 

  3. Sola C, Filliol I, Legrand E, Mokrousov I, Rastogi N (2001) Mycobacterium tuberculosis phylogeny reconstruction based on combined numerical analysis with IS1081, IS6110, VNTR, and DR-based spoligotyping suggests the existence of two new phylogeographical clades. J Mol Evol 53:680–689

    Article  CAS  PubMed  Google Scholar 

  4. Soolingen D van, Qian L, Haas PEW de, Douglas JT, Traore H, Portaels F, Quing Z, Enkhasaikan D, Nymadawa P, Embden JDA van (1995) Predominance of a single genotype of Mycobacterium tuberculosis in countries of East Asia. J Clin Microbiol 33:3234–3238

    PubMed  Google Scholar 

  5. Sola C, Filliol I, Guttieres MC, Mokrousov I, Vincent V, Rastogi N (2001) Spoligotype database of Mycobacterium tuberculosis: biogeographic distribution of shared types and epidemiologic and phylogenetic perspectives. Emerg Infect Dis 7:390–396

    CAS  PubMed  Google Scholar 

  6. Bifani PJ, Mathema B, Kurepina NE, Kreiswirth BN (2002) Global dissemination of the Mycobacterium tuberculosis W-Beijing family strains. Trends Microbiol 10:45–52

    Article  CAS  PubMed  Google Scholar 

  7. Bifani PJ, Mathema B, Liu Z, Moghazeh SL, Shopsin B, Tempalski B, Driscol J, Frothingham R, Musser JM, Alcabes P, Kreiswirth BN (1999) Identification of a W variant outbreak of Mycobacterium tuberculosis via population-based molecular epidemiology. JAMA 282:2321–2327

    Article  CAS  PubMed  Google Scholar 

  8. Plikaytis BB, Marden JL, Crawford JT, Woodley CL, Butler WR, Shinnick TM (1994) Multiplex PCR assay specific for the multidrug-resistant strain W of Mycobacterium tuberculosis. J Clin Microbiol 32:1542–1546

    CAS  PubMed  Google Scholar 

  9. Fang Z, Kenna DT, Doig C, Smittipat DN, Palittapongarnpim P, Watt B, Forbes KJ (2001) Molecular evidence for independent occurrence of IS6110 insertions at the same sites of the genome of Mycobacterium tuberculosis in different clinical isolates. J Bacteriol 183:5279–5284

    Article  CAS  PubMed  Google Scholar 

  10. Fang Z, Forbes KJ (1997) A Mycobacterium tuberculosis IS6110 preferential locus (ipl) for insertion into the genome. J Clin Microbiol 35:479–481

    CAS  PubMed  Google Scholar 

  11. Sampson SL, Warren RM, Richardson M, Spuy GD van der, Helden P van (1999) Disruption of coding regions by IS6110 insertion in Mycobacterium tuberculosis. Tuberc Lung Dis 79:349–359

    Article  CAS  Google Scholar 

  12. Jansen R, Embden JDA van, Gaastra W, Schouls LM (2002) Identification of genes that are associated with DNA repeats in prokaryotes. Mol Microbiol 43:1565–1575

    Article  CAS  PubMed  Google Scholar 

  13. Glynn JR, Whiteley J, Bifani PJ, Kremer K, Soolingen D van (2002) Worldwide occurrence of Beijing/W strains of Mycobacterium tuberculosis: a systematic review. Emerg Infect Dis 8:843–849

    PubMed  Google Scholar 

  14. Bifani PJ, Mathema B, Campo M, Moghazeh S, Nivin B, Shashkina E, Driscoll J, Munsiff SS, Frothingham R, Kreiswirth BN (2001) Molecular identification of streptomycin monoresistant Mycobacterium tuberculosis related to multidrug-resistant W strain. Emerg Infect Dis 7:842–848

    CAS  PubMed  Google Scholar 

  15. Mokrousov I, Narvskaya O, Limeschenko E, Otten T, Vyshnevskyi B (2002) Novel IS6110 insertion sites in the direct repeat locus of Mycobacterium tuberculosis clinical strains from the St. Petersburg area of Russia, and evolutionary and epidemiological considerations. J Clin Microbiol 40:1504–1507

    Article  CAS  PubMed  Google Scholar 

  16. Narvskaya O, Mokrousov I, Otten TF, Vyshnevskiy BI (1999) Genetic marking of polyresistant Mycobacterium tuberculosis strains isolated in the north-west of Russia. Probl Tuberk N3:39–41

    Google Scholar 

  17. Mokrousov I, Narvskaya O, Otten T, Limeschenko E, Steklova L, Vyshnevskyi B (2002) High prevalence of KatG Ser315Thr substitution among isoniazid-resistant Mycobacterium tuberculosis clinical isolates from northwestern Russia, 1996 to 2001. Antimicrob Agents Chemother 46:1417–1424

    Article  CAS  PubMed  Google Scholar 

  18. Ramaswamy SV, Musser JM (1998) Molecular genetic basis of antimicrobial agent resistance in Mycobacterium tuberculosis: 1998 update. Tuber Lung Dis 79:3–29

    Article  CAS  PubMed  Google Scholar 

  19. Victor TC, Helden PD van, Warren R (2002) Prediction of drug resistance in M. tuberculosis: molecular mechanisms, tools and applications. IUBMB Life 53:231–237

    CAS  PubMed  Google Scholar 

  20. Mokrousov I, Filliol I, Legrand E, Sola C, Otten T, Vyshnevskaya E, Limeschenko E, Vyshnevskiy B, Narvskaya O, Rastogi N (2002) Molecular characterization of multiple-drug-resistant Mycobacterium tuberculosis isolates from north-western Russia and analysis of rifampin resistance using RNA/RNA mismatch analysis as compared to the line-probe assay and sequencing of the rpoB gene. Res Microbiol 153:213–219

    Article  CAS  PubMed  Google Scholar 

  21. Narvskaya O, Mokrousov I, Limeschenko E, Otten T, Steklova L, Graschenkova O, Vishnevsky B (2000) Molecular characterization of Mycobacterium tuberculosis strains from north-west region of Russia. EpiNorth 2:22–24

    Google Scholar 

  22. Marttila HJ, Soini H, Eerola E, Vyshnevskaya E, Vyshnevskiy BI, Otten TF, Vasilyef AV, Viljanen M (1998) A Ser315Thr substitution in KatG is predominant in genetically heterogeneous multidrug-resistant Mycobacterium tuberculosis isolates originating from the St. Petersburg area in Russia. Antimicrob Agents Chemother 42:2443–2445

    CAS  PubMed  Google Scholar 

  23. Toungoussova OS, Sandven P, Mariandyshev AO, Nizovtseva NI, Bjune G, Caugant DA (2002) Spread of drug-resistant Mycobacterium tuberculosis strains of the Beijing genotype in the Archangel Oblast, Russia. J Clin Microbiol 40:1930–1937

    Article  CAS  PubMed  Google Scholar 

  24. Generozov EV, Akopian TA, Govorun VM, Chernoussova LN, Larionova EE, Savinkova SN, Smirnova TG, Golyshevskaia VI, Khomenko AG (2000) Molecular characteristics of multiresistant clinical strains of Mycobacterium tuberculosis isolated in Russia. Mol Genet Mikrobiol Virusol N1:11–17

    Google Scholar 

  25. Narvskaya O, Otten T, Limeschenko E, Sapozhnikova N, Graschenkova O, Steklova L, Nikonova A, Filipenko ML, Mokrousov I, Vyshnevskiy B (2002) Nosocomial outbreak of multidrug-resistant tuberculosis caused by a strain of Mycobacterium tuberculosis W-Beijing family in St. Petersburg, Russia. Eur J Clin Microbiol Infect Dis 21:596–602

    Article  CAS  PubMed  Google Scholar 

  26. Mokrousov I, Narvskaya O, Otten T, Vyazovaya A, Limeschenko E, Steklova L, Vyshnevskyi B (2002) Phylogenetic reconstruction within Mycobacterium tuberculosis Beijing genotype in northwestern Russia. Res Microbiol 153:629–637

    Article  CAS  PubMed  Google Scholar 

  27. World Health Organization (1993) Treatment of tuberculosis. Guidelines for national programs. WHO, Geneva

  28. Viljanen MK, Vyshnevskiy BI, Otten TF, Vyshnevskaya E, Marjamäki M, Soini H, Laippala PJ, Vasilyef AV (1998) Survey of drug-resistant tuberculosis in northwestern Russia from 1984 through 1994. Eur J Clin Microbiol Infect Dis 17:177–183

    CAS  PubMed  Google Scholar 

  29. World Health Organization (1998) Laboratory services in tuberculosis control. Part III. Culture. Document no. WHO/TB/98.258. WHO, Geneva

  30. Dragon EA, Spadoro JP, Madej R (1993) Quality control of polymerase chain reaction. In: Persing DH, Smith TF, Tenover FC, White TJ (eds) Diagnostic molecular microbiology. American Society for Microbiology, Washington DC, pp 160–168

  31. Mokrousov I, Otten T, Filipenko M, Vyazovaya A, Chrapov E, Limeschenko E, Steklova L, Vyshnevskiy B, Narvskaya O (2002) Detection of isoniazid-resistant Mycobacterium tuberculosis strains by multiplex allele-specific PCR assay targeting katG codon 315 variation. J Clin Microbiol 40:2509–2512

    Article  CAS  PubMed  Google Scholar 

  32. Kamerbeek J, Schouls L, Kolk A, Agterveld M van, Soolingen D van, Kuijper S, Bunschoten A, Molhuizen H, Shaw R, Goyal M, Embden JDA van (1997) Simultaneous detection and strain differentiation of Mycobacterium tuberculosis for diagnosis and epidemiology. J Clin Microbiol 35:907–914

    CAS  PubMed  Google Scholar 

  33. Embden JDA van, Cave MD, Crawford JT, Dale JW, Eisenach KD, Gicquel B, Hermans P, Martin C, McAdam R, Shinnick TM, Small PM (1993) Strain identification of Mycobacterium tuberculosis by DNA fingerprinting: recommendations for a standardized methodology. J Clin Microbiol 31:406–409

    PubMed  Google Scholar 

  34. Friedman CR, Stoeckle M, Johnson WD Jr, Riley LW (1995) Double-repetitive-element PCR method for subtyping Mycobacterium tuberculosis clinical isolates. J Clin Microbiol 33:1383–1384

    CAS  PubMed  Google Scholar 

  35. Ross BC, Dwyer B (1993) Rapid, simple method for typing isolates of Mycobacterium tuberculosis by using the polymerase chain reaction. J Clin Microbiol 31:329–334

    CAS  PubMed  Google Scholar 

  36. Krüüner A, Hoffner SE, Sillastu H, Danilovits M, Levina K, Svenson SB, Ghebremichael S, Koivula T, Källenius G (2001) Spread of drug-resistant pulmonary tuberculosis in Estonia. J Clin Microbiol 39:3339–3345

    Article  PubMed  Google Scholar 

  37. Crevel R van, Nelwan RH, Lenne W de, Veeraragu Y, der Zanden AG van, Amin Z, Meer JW van der, Soolingen D van (2001) Mycobacterium tuberculosis Beijing genotype strains associated with febrile response to treatment. Emerg Infect Dis 7:880–883

    PubMed  Google Scholar 

  38. Zhang M, Cong J, Yang Z, Samten B, Barnes PF (1999) Enhanced capacity of a widespread strain of Mycobacterium tuberculosis to grow in human macrophages. J Infect Dis 179:1213–1217

    Article  CAS  PubMed  Google Scholar 

  39. Chernoussova LN, Andreevskaya SN, Smirnova TG, Katulina NI, Shudrova MA (2001) Genotyping of mycobacteria recovered from the tuberculosis patients from a penitentiary hospital. Probl Tuberk N7:60–62

    Google Scholar 

  40. Portaels F, Rigouts L, Bastian I (1999) Addressing multidrug-resistant tuberculosis in penitentiary hospitals and in the general population of the former Soviet Union. Int J Tuber Lung Dis 3:582–588

    Google Scholar 

  41. Pfyffer GE, Strassle A, Gorkom T van, Portaels F, Rigouts L, Mathieu C, Mirzoev F, Traore H, Embden JDA van (2001) Multidrug-resistant tuberculosis in prison inmates, Azerbaijan. Emerg Infect Dis 7:855–861

    CAS  PubMed  Google Scholar 

  42. Qian L, Abe C, Lin TP, Yu MC, Cho SN, Wang S, Douglas JT (2002) rpoB genotypes of Mycobacterium tuberculosis Beijing family isolates from East Asian countries. J Clin Microbiol 40:1091–1094

    Article  CAS  PubMed  Google Scholar 

  43. Rie A van, Warren R, Mshanga I, Jordaan AM, Spuy GD van der, Richardson M, Simpson J, Gie RP, Enarson DA, Beyers N, Helden PD van, Victor TC (2001) Analysis for a limited number of gene codons can predict drug resistance of Mycobacterium tuberculosis in a high-incidence community. J Clin Microbiol 39:636–641

    Article  PubMed  Google Scholar 

  44. Mokrousov I, Otten T, Vyshnevskiy B, Narvskaya O (2002) Detection of embB306 mutations in ethambutol-susceptible Mycobacterium tuberculosis clinical isolates from northwestern Russia: implications for genotypic resistance testing. J Clin Microbiol 40:3810–3813

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We thank Jan D.A. van Embden for kindly providing us with DNA samples and Robert A. Ollar for critical reading of the manuscript and language corrections. This study was partly supported by the "Délégation Générale au Réseau International des Instituts Pasteur et Instituts Associés", Institut Pasteur, Paris, and the International Atomic Energy Agency, Research Contract no. 9924.

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Mokrousov, I., Otten, T., Vyazovaya, A. et al. PCR-Based Methodology for Detecting Multidrug-Resistant Strains of Mycobacterium tuberculosis Beijing Family Circulating in Russia. Eur J Clin Microbiol Infect Dis 22, 342–348 (2003). https://doi.org/10.1007/s10096-003-0944-0

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