Molecular epidemiology of tuberculosis in Cambodian children

SUMMARY
We analysed Mycobacterium tuberculosis strains from children, hospitalized from January 2004
to July 2008 in the largest paediatric hospital complex in Cambodia. Specimens were tested for
drug susceptibility and genotypes. From the 260 children, 161 strains were available. The East
African-Indian genotype family was the most common (59·0%), increasing in frequency with
distance from the Phnom Penh area, while the frequency of the Beijing genotype family strains
decreased. The drug resistance pattern showed a similar geographical gradient: lowest in the
northwest (4·6%), intermediate in the central (17·1%), and highest in the southeastern (30·8%)
parts of the country. Three children (1·9%) had multidrug-resistant tuberculosis. The Beijing
genotype and streptomycin resistance were significantly associated (P<0·001). As tuberculosis in
children reflects recent transmission patterns in the community, multidrug resistance levels inform
about the current quality of the tuberculosis programme.

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