Molecular surveillance of multi- and extensively drug-resistant tuberculosis transmission in the European Union from 2003 to 2011

J L De Beer; C Ködmön; M J van der Werf; J van Ingen; D van Soolingen; Collective the ECDC MDR-TB molecular surveillance project participants

doi:10.2807/1560-7917.ES2014.19.11.20742

Surveillance and outbreak reports Open Access

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Molecular surveillance of multi- and extensively drug-resistant tuberculosis transmission in the European Union from 2003 to 2011
J L De Beer¹ , C Ködmön² , M J van der Werf² , J van Ingen³ , D van Soolingen^1,3,4 , Collective the ECDC MDR-TB molecular surveillance project participants⁵
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Affiliations: ¹ National Tuberculosis Reference Laboratory, Laboratory for Infectious Diseases and Perinatal Screening (LIS), Centre for Infectious Disease Control (CIB), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands ² European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden ³ Department of Medical Microbiology, Department of Medical Microbiology Nijmegen, The Netherlands ⁴ Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands ⁵ The participants are listed at the end of the article

Correspondence:
J De Beer
jessica.de.beer rivm.nl
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Citation style for this article: De Beer J L, Ködmön C, van der Werf M J, van Ingen J, van Soolingen D, the ECDC MDR-TB molecular surveillance project participants Collective. Molecular surveillance of multi- and extensively drug-resistant tuberculosis transmission in the European Union from 2003 to 2011. Euro Surveill. 2014;19(11):pii=20742. https://doi.org/10.2807/1560-7917.ES2014.19.11.20742 Received: 24 May 2013

Abstract

The European Centre for Disease Prevention and Control (ECDC) initiated a project on the molecular surveillance of multi- and extensively drug-resistant tuberculosis (MDR-/XDR-TB) transmission in the European Union (EU) in the period from 2009 to 2011. In total, 2,092 variable number of tandem repeat (VNTR) patterns of MDR-/XDR-TB Mycobacterium tuberculosis isolates were collected, originating from 24 different countries in the period 2003 to 2011. Of the collected VNTR patterns, 45% (n=941) could be assigned to one of the 79 European multiple-country molecular fingerprint clusters and 50% of those (n=470) belonged to one extremely large cluster caused by Beijing strains of one genotype. We conclude that international transmission of MDR-/XDR-TB plays an important role in the EU, especially in the eastern part, and is significantly related to the spread of one strain or clone of the Beijing genotype. Implementation of international cluster investigation in EU countries should reveal underlying factors of transmission, and show how TB control can be improved regarding case finding, contact tracing, infection control and treatment in order to prevent further spread of MDR-/XDR-TB in the EU.