Beijing/W genotype Mycobacterium tuberculosis and drug resistance

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.

Figure

Distribution of Beijing genotype tuberculosis (TB). Size of circle indicates percentage of TB cases due to Beijing genotype; color in circle indicates drug sensitivity and distribution trend. Blue, pattern 1 (stable, no association with drug resistance); red, pattern 2 (increasing, associated with drug resistance); green, pattern 3 (increasing, drug sensitive); yellow, pattern 4 (absent); striped, trend or association with drug resistance not known.