Abstract:
Understanding the molecular epidemiology of tuberculosis (TB) and mutations in genes associated with
drug resistance may contribute to the development of appropriate interventions to improve tuberculosis
control. A structured questionnaire was used to collect basic epidemiological data from 589 patients
with radiologically confirmed TB in the Odessa and Nikolaev regions of the Ukraine in 2003–2004. A
non-commercial reverse hybridisation assay and DNA sequencing were used to detect mutations
associated with rifampicin and isoniazid resistance. Genotyping was performed using multilocus
variable number tandem repeat (VNTR) typing and spoligotyping. Mutations conferring rifampicin and
isoniazid resistance were detected in 32.9% and 44.0%, respectively, of 225 Mycobacterium tuberculosis
isolates from individual consecutive patients. Mutations in codon 531 and codon 315 of the rpoB and
katG genes, respectively, were predominant among drug-resistant isolates. Multidrug (MDR) resistance
rates were significantly higher among former prison inmates compared with non-prisoners (54.8% vs.
27.3%; RR 2.01; 95% CI 1.35–2.97) and the prevalence of mutations was higher in Beijing strains sharing
the VNTR signature 223325173533424 than in other Beijing strains (71.4% vs. 45.7%; RR 1.74; 95% CI
1.17–2.57), suggesting that this group may be responsible for rapid transmission of MDR TB in the
southern Ukraine.
