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RESEARCH NOTE
Distribution of Phagetype Patterns of Mycobacterium tuberculosis Isolated in Cuba (1987-1991) Carlos A Jimenez-Misas, Jose A Valdivia Alvarez
Code Number: OC94029
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Instituto de Medicina Tropical "Pedro Kouri", Laboratorio Nacional de Referencia de Mycobacteria y Tuberculosis, Marianao 13, ZP 11 300, Ciudad de la Habana, Cuba
Key words: Mycobacterium tuberculosis - phagetyping
The provincial distribution of different Mycobacterium tuberculosis phage types in Cuba is reported through the identification of 918 strains from Cuban tuberculosis patients. The isolation of strains was performed between 1987 and 1991 when diagnosed and before the beginning of the treatment. The analysis carried out showed a relatively homogenous distribution of A, Ax and I types in all the provinces of the country, predominating phagetype A (56.97%) followed by the phagetypes I (35.06%), Ax (4.24%), C (1.09%), and B (1.01%), in that order.
Many reports of mycobacterial characterization using bacteriophages for typing have followed the studies of GM Garder and RS Weiser (1947 Proc Soc Exp Biol Med 66: 205-206) and S Froman et al. (1954 Am J Pub Health 44: 1326-1333) who isolated for the first time, active phages capable of lysing M. smegmatis and M. tuberculosis, respectively.
Studies carried out on the division of M. tuberculosis into types and sub-types through specific bacteriophages have gained importance in the epidemiological and clinical control of tuberculosis (WD Jones et al. 1982 Am Rev Respir Dis 125: 640-643, S Clavel-Seres et al. 1988 Rev Mal Resp 5: 577-581).
Through studies made in several countries, the distribution of phagetypes of M. tuberculosis in different regions of the world has been reported allowing the differentiation of strains introduced by immigrants, particularly in those countries that are controlling and reducing their tuberculosis rate (S Clavel-Seres & F Clement 1984 Ann Microbiol (Inst Pasteur) 135B: 35-44, WD Jones 1990 Am Rev Respir Dis 142: 1000-1003).
As part of the standardization of this thecnique in 1989, CA Jimenez-Misas et al. (1989 Mem Inst Oswaldo Cruz 84: 271) reported a preliminary study of the distribution of M. tuberculosis phagetypes in Cuba. The absense of phagetype B was described in 227 strains studied.
The purpose of the present report was to determine the phagetype distribution by province of M. tuberculosis covering a considerable portion of the total M. tuberculosis isolates between 1987 and 1991. This study represents a more complete M. tuberculosis phagetypes distribution in a country of the Latin American region. Phagetyping was applied to a total of 918 strains of M. tuberculosis by the techniques initially described by W Redmond and D Ward (1966 Bull WHO 35: 563-568) with the modifications introduced by TA Rado et al. (1977 Am Rev Respir Dis 115 (Suppl): 268) as well as those described by JM Grange et al. (1977 Tubercle 58: 207-215).
The Table summarizes the results and percentages of M. tuberculosis phagetype distribution for all provinces. This enables a comparison between the individual results of each province and the rest of the provinces. These results demonstrate a higher proportion of phagetype A (56.97%) and I (35.06%), followed by types Ax (4.24%), C (1.09%), B (1.01%). Except for the provinces of Matanzas, Ciego de Avila, Holguin and Guantanamo, a certain homogeneity in the Cuban population was observed in relation to the distribution of phagetypes A, Ax and I. As for the capital of the country (Ciudad de La Habana), La Habana, Pinar del Rio, Villa Clara and Santiago de Cuba, the patterns reported represent all M. tuberculosis types. It must be noted, however, that in spite of the large number of strains studies, not all of the provinces are equally represented according to their actual tuberculosis incident rates.
Acknowledgements: to Dr Wilbur D Jones, for the critical and skilled revision of the manuscript and pertinent suggestions.
TABLE
Mycobacterium tuberculosis phagetype provincial distribution in Cuba (1987-1991)
====================================================================== Phagetypes ---------------------------------------------------- Province Total A % Ax % I % B % C % ---------------------------------------------------------------------- Pinar del Rio 62 36 58.0 5 8.0 17 27.4 2 3.2 2 3.2 Ciudad de La Habana 259 180 69.4 3 1.1 69 26.6 3 1.1 4 1.5 La Habana 30 12 40.0 1 3.3 15 50.0 1 3.3 1 3.3 Isla de la Juventud 20 12 60.0 1 5.0 6 30.0 1 5.0 Matanzas 54 34 62.9 - 19 35.1 1 1.8 - Villa Clara 103 60 58.2 2 1.9 36 34.9 2 1.9 3 2.9 Cienfuegos 40 29 72.5 2 5.0 8 20.0 1 2.5 Sancti Spiritus 25 7 28.0 4 16.0 14 56.0 - Ciego de Avila 19 14 73.6 5 26.3 - - Camaguey 87 34 39.0 3 3.4 46 52.8 4 4.5 Las Tunas 38 6 15.7 3 7.8 29 76.3 - Granma 46 18 39.1 6 13.0 22 52.1 - Holguin 30 23 76.6 - 7 23.3 - Santiago de Cuba 80 38 47.5 4 5.0 34 42.5 2 2.5 2 2.5 Guantanamo 25 20 80.0 - 5 20.0 - ---------------------------------------------------------------------- Total 918 523 39 327 11 18 (56.97) (4.24) (35.06) (1.01) (1.09) ====================================================================== Copyright 1994 Fundacao Oswaldo Cruz - FIOCRUZ |
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