Beijing/W Genotype Mycobacterium tuberculosis & Drug Resistance
Beijing/W Genotype Mycobacterium tuberculosis & Drug Resistance
Beijing/W genotype Mycobacterium tuberculosis is widespread, may be increasing, and may have a predilection for drug resistance. Individual-level data on >29,000 patients from 49 studies in 35 countries were combined to assess the Beijing genotype's prevalence worldwide, trends over time and with age, and associations with drug resistance. We found 4 patterns for Beijing/W genotype tuberculosis (TB): 1) endemic, not associated with drug resistance (high level in most of East Asia, lower level in parts of the United States); 2) epidemic, associated with drug resistance (high level in Cuba, the former Soviet Union, Vietnam, and South Africa, lower level in parts of Western Europe); 3) epidemic but drug sensitive (Malawi, Argentina); and 4) very low level or absent (parts of Europe, Africa). This study confirms that Beijing/W genotype TB is an emerging pathogen in several areas and a predominant endemic strain in others; it is frequently associated with drug resistance.
The Mycobacterium tuberculosis genotype family known as "Beijing/W," "W-Beijing," or "Beijing" is widespread. Described in 1995 as the prevalent genotype in East Asia, >80% of strains from the Beijing area were of this type. The multidrug-resistant W strain is a member of the family. We use "Beijing" for the whole genotype family.
Researchers are concerned that the Beijing genotype may have a predilection for developing drug resistance and may be spreading worldwide, perhaps as a result of increased virulence. A systematic review of the published literature in 2002 concluded that although Beijing genotype tuberculosis (TB) was widespread, associations with drug resistance varied, and little information on time trends was available.
The review highlighted the problems of relying on published literature: varying strain definitions; reporting bias; and limited information on selection criteria, population subgroups, age groups, or time trends. As part of the European Concerted Action on New Generation Genetic Markers and Techniques for the Epidemiology and Control of Tuberculosis, we have combined available datasets, using a common strain definition and individual-level data.
Abstract and Introduction
Abstract
Beijing/W genotype Mycobacterium tuberculosis is widespread, may be increasing, and may have a predilection for drug resistance. Individual-level data on >29,000 patients from 49 studies in 35 countries were combined to assess the Beijing genotype's prevalence worldwide, trends over time and with age, and associations with drug resistance. We found 4 patterns for Beijing/W genotype tuberculosis (TB): 1) endemic, not associated with drug resistance (high level in most of East Asia, lower level in parts of the United States); 2) epidemic, associated with drug resistance (high level in Cuba, the former Soviet Union, Vietnam, and South Africa, lower level in parts of Western Europe); 3) epidemic but drug sensitive (Malawi, Argentina); and 4) very low level or absent (parts of Europe, Africa). This study confirms that Beijing/W genotype TB is an emerging pathogen in several areas and a predominant endemic strain in others; it is frequently associated with drug resistance.
Introduction
The Mycobacterium tuberculosis genotype family known as "Beijing/W," "W-Beijing," or "Beijing" is widespread. Described in 1995 as the prevalent genotype in East Asia, >80% of strains from the Beijing area were of this type. The multidrug-resistant W strain is a member of the family. We use "Beijing" for the whole genotype family.
Researchers are concerned that the Beijing genotype may have a predilection for developing drug resistance and may be spreading worldwide, perhaps as a result of increased virulence. A systematic review of the published literature in 2002 concluded that although Beijing genotype tuberculosis (TB) was widespread, associations with drug resistance varied, and little information on time trends was available.
The review highlighted the problems of relying on published literature: varying strain definitions; reporting bias; and limited information on selection criteria, population subgroups, age groups, or time trends. As part of the European Concerted Action on New Generation Genetic Markers and Techniques for the Epidemiology and Control of Tuberculosis, we have combined available datasets, using a common strain definition and individual-level data.
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