ArticlePloS one2013
Programmatically selected multidrug-resistant strains drive the emergence of extensively drug-resistant tuberculosis in South Africa.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.
- Molecular epidemiology of drug resistant Mycobacterium tuberculosis in Africa: a systematic review.BMC infectious diseases · 2020Pooled it
- Predicting resistance to fluoroquinolones among patients with rifampicin-resistant tuberculosis using machine learning methods.PLOS digital health · 2022Article
- Magnitude of Multidrug Resistance and Associated Factors of Pulmonary Tuberculosis Among Adult Smear Positive Patients in Eastern Ethiopia.Infection and drug resistance · 2021Article
- Linezolid resistance in patients with drug-resistant TB and treatment failure in South Africa.The Journal of antimicrobial chemotherapy · 2019Article
- Whole genome sequencing for drug resistance determination inAfrican journal of laboratory medicine · 2019Article
- Insights into the processes that drive the evolution of drug resistance inEvolutionary applications · 2018Review
- Article
- Multi-clonal evolution of multi-drug-resistant/extensively drug-resistant Mycobacterium tuberculosis in a high-prevalence setting of Papua New Guinea for over three decades.Microbial genomics · 2018Article
- Comparison of line probe assay to BACTEC MGIT 960 system for susceptibility testing of first and second-line anti-tuberculosis drugs in a referral laboratory in South Africa.BMC infectious diseases · 2017Article
- Stool Culture for Diagnosis of Pulmonary Tuberculosis in Children.Journal of clinical microbiology · 2017Article
- Molecular analysis of pyrazinamide resistance in Mycobacterium tuberculosis in Vietnam highlights the high rate of pyrazinamide resistance-associated mutations in clinical isolates.Emerging microbes & infections · 2017Article
- Of Testing and Treatment: Implications of Implementing New Regimens for Multidrug-Resistant Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Article
- Fitness-compensatory mutations facilitate the spread of drug-resistant F15/LAM4/KZN and F28 Mycobacterium tuberculosis strains in KwaZulu-Natal, South Africa.Journal of genetics · 2017Article
- The within-host population dynamics of Mycobacterium tuberculosis vary with treatment efficacy.Genome biology · 2017Article
- Second line drug susceptibility testing to inform the treatment of rifampin-resistant tuberculosis: a quantitative perspective.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2017Review
- Isoniazid-resistant tuberculosis: a cause for concern?The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2017Review
- Paradoxical Hypersusceptibility of Drug-resistant Mycobacteriumtuberculosis to β-lactam Antibiotics.EBioMedicine · 2016Article
- A Novel Molecular Strategy for Surveillance of Multidrug Resistant Tuberculosis in High Burden Settings.PloS one · 2016Article
- Data for action: collection and use of local data to end tuberculosis.Lancet (London, England) · 2015Review
- The Race Is On To Shorten the Turnaround Time for Diagnosis of Multidrug-Resistant Tuberculosis.Journal of clinical microbiology · 2015Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundSouth Africa shows one of the highest global burdens of multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB). Since 2002, MDR-TB in South Africa has been treated by a standardized combination therapy, which until 2010 included ofloxacin, kanamycin, ethionamide, ethambutol and pyrazinamide. Since 2010, ethambutol has been replaced by cycloserine or terizidone. The effect of standardized treatment on the acquisition of XDR-TB is not currently known.
methodsWe genetically characterized a random sample of 4,667 patient isolates of drug-sensitive, MDR and XDR-TB cases collected from three South African provinces, namely, the Western Cape, Eastern Cape and KwaZulu-Natal. Drug resistance patterns of a subset of isolates were analyzed for the presence of commonly observed resistance mutations.
resultsOur analyses revealed a strong association between distinct strain genotypes and the emergence of XDR-TB in three neighbouring provinces of South Africa. Strains predominant in XDR-TB increased in proportion by more than 20-fold from drug-sensitive to XDR-TB and accounted for up to 95% of the XDR-TB cases. A high degree of clustering for drug resistance mutation patterns was detected. For example, the largest cluster of XDR-TB associated strains in the Eastern Cape, affecting more than 40% of all MDR patients in this province, harboured identical mutations concurrently conferring resistance to isoniazid, rifampicin, pyrazinamide, ethambutol, streptomycin, ethionamide, kanamycin, amikacin and capreomycin.
conclusionsXDR-TB associated genotypes in South Africa probably were programmatically selected as a result of the standard treatment regimen being ineffective in preventing their transmission. Our findings call for an immediate adaptation of standard treatment regimens for M/XDR-TB in South Africa.
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