caa a22 4500 606155236 CHVBK 20210128100602.0 cr unu---uuuuu 210128e20150101xx s 000 0 eng 10.1007/s10096-014-2202-z doi (NATIONALLICENCE)springer-10.1007/s10096-014-2202-z A close-up on the epidemiology and transmission of multidrug-resistant tuberculosis in Poland [Elektronische Daten] [T. Jagielski, A. Brzostek, A. van Belkum, J. Dziadek, E. Augustynowicz-Kopeć, Z. Zwolska] Multidrug-resistant tuberculosis (MDR-TB) poses a serious challenge to the global control of the disease. The purpose of this study was to characterize MDR-TB patients from Poland and to determine the extent of MDR-TB disease attributable to recent transmission. The study included all 46 patients diagnosed with MDR-TB in Poland in 2004 and followed up for 6years (until 2011). For each patient, sociodemographic and clinical characteristics, treatment outcomes, and bacteriological data were collected by the review of medical and laboratory records. Mycobacterium tuberculosis isolates from all patients were characterized using spoligotyping, mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing, IS6110 restriction fragment length polymorphism (RFLP) analysis, and sequencing analysis of drug resistance-associated loci (katG, mabA-inhA, rpoβ, rpsL, and embB). The majority of patients were male (86.9%), 40-64years of age (60.8%), with a history of TB treatment (84.8%), and producing smear-positive sputa (86.9%). Twenty-two (47.8%) patients suffered from concomitant diseases and 28 (60.8%) were alcohol abusers. Treatment outcome assessment revealed that 8 (17.4%) patients were cured or completed therapy, while 15 (32.6%) died of TB, 11 (23.9%) defaulted, 8 (17.4%) failed, and 1 (2.2%) was transferred and lost to follow-up. Upon genotyping, 10 (21.7%) isolates were allocated in four clusters. These were further subdivided by mutational profiling. Overall, in 6 (13%) patients, MDR-TB was a result of recent transmission. For 4 (8.7%) of these patients, a direct epidemiological link was established. The study shows that the transmission of MDR-TB occurs at a low rate in Poland. Of urgent need is the implementation of a policy of enforced treatment of MDR-TB patients in Poland. Springer-Verlag Berlin Heidelberg, 2014 Jagielski T. Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096, Warsaw, Poland aut Brzostek A. Laboratory of Mycobacterium Genetics and Physiology, Institute of Medical Biology, Polish Academy of Sciences, Łódź, Poland aut van Belkum A. bioMérieux, Clinical Unit, Microbiology R&D, La Balme Les Grottes, France aut Dziadek J. Laboratory of Mycobacterium Genetics and Physiology, Institute of Medical Biology, Polish Academy of Sciences, Łódź, Poland aut Augustynowicz-Kopeć E. Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland aut Zwolska Z. Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/1(2015-01-01), 41-53 0934-9723 34:1<41 2015 34 10096 https://doi.org/10.1007/s10096-014-2202-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2202-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jagielski T. Department of Applied Microbiology, Institute of Microbiology, Faculty of Biology, University of Warsaw, I. Miecznikowa 1, 02-096, Warsaw, Poland aut NATIONALLICENCE 700 1- Brzostek A. Laboratory of Mycobacterium Genetics and Physiology, Institute of Medical Biology, Polish Academy of Sciences, Łódź, Poland aut NATIONALLICENCE 700 1- van Belkum A. bioMérieux, Clinical Unit, Microbiology R&D, La Balme Les Grottes, France aut NATIONALLICENCE 700 1- Dziadek J. Laboratory of Mycobacterium Genetics and Physiology, Institute of Medical Biology, Polish Academy of Sciences, Łódź, Poland aut NATIONALLICENCE 700 1- Augustynowicz-Kopeć E. Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland aut NATIONALLICENCE 700 1- Zwolska Z. Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/1(2015-01-01), 41-53 0934-9723 34:1<41 2015 34 10096