European Society of Mycobacteriology - Instituto Nacional de Saúde ...

PP-6
SPOLIGOTYPE PATTERNS AND DRUG RESISTANT
PROFILE OF Mycobacterium tuberculosis IN SUDAN
Ghada Suliman Sharaf-Eldin 1 , Imad F.Elmoula 1 , Mohammed S. Ali 1 , Nageeb S. Saaed 2 ,
Ahammed B Ali 1 , Kim Mallard 3 , Ruth McNerney 3 , Saad Algamdi 3
1 - Al Neelain University-Sudan
2 - National Health Laboratory-Sudan
3 - London School of Hygiene & Tropical Medicine.
Sudan has a high burden of tuberculosis with an estimated 93,000 new cases each year. The purpose of this
study was to investigate the genotypic patterns of M. tuberculosis strains circulating in Sudan and to assess
their susceptibly to anti-tuberculosis drugs. Isolates from 237 smear positive tuberculosis patients were collected
from different geographic regions of the country. Spoligotyping was performed by the Kamerbeek
method and results were compared with the international SpolDB4 database (Institut Pasteur, Guadeloupe).
Results revealed 28 clusters ranging in size from 12 to 57 isolates. Seventy unique (unclustered) strains were observed,
representing 30% of the strains examined. The most frequently observed spoligotype patterns belonged to the CAS family
which represented 115 (48.5%) of isolates studied. T1, H3, U and Beijing strains were found in 12 (5.1%), 11 (4.6%),
7 (3%) and 6 (2.5%) patients respectively. Strains belonging to the Beijing family were found mainly in Western Sudan.
Resistance to isoniazid, rifampicin, ethambutol and streptomycin was observed in 18.1, 22.4, 22.2 and 32% of strains respectively.
Twenty patients (8.4%) had MDR-TB of which 10 were new cases. Seventeen patients with rifampicin resistant
tuberculosis were infected with CAS1-DELHI strains matching SIT 25 of the SpolDB4 database and 3 were of the SIT
1 Beijing family. 15 loci MIRU-VNTR typing subdivided the 17 CAS strains into one cluster of 5, two clusters of 2 and
8 individual MIRU types. Similarly the 3 Beijing spoligotypes were differentiated into a cluster of 2 and a single strain.
The use of molecular strain typing provides a proactive approach that may be used to initiate, and not just augment,
traditional surveillance outbreak investigation in Sudan. However, caution must be used when interpreting clustered
spoligotype patterns in this region.
European Society of Mycobacteriology | 30 th Annual Congress | July 2009 | Porto - Portugal
79