Abstract
A retrospective population-based molecular epidemiologic study of multidrug-resistant Mycobacterium tuberculosis complex strains in Serbia (2008-2014) revealed an outbreak of TUR genotype strains in a psychiatric hospital starting around 1990. Drug unavailability, poor infection control, and schizophrenia likely fueled acquisition of additional resistance and bacterial fitness-related mutations over 2 decades.
Keywords:
MDR TB; Serbia; antimicrobial resistance; bacteria; multidrug-resistant; outbreak; transmission; tuberculosis; tuberculosis and other mycobacteria; whole-genome sequencing.
MeSH terms
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Adolescent
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Adult
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Aged
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Aged, 80 and over
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Antitubercular Agents / pharmacology
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Cross Infection / epidemiology*
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Cross Infection / microbiology*
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Disease Outbreaks*
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Female
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Genome, Bacterial
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Genotype
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Hospitals
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Humans
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Male
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Microbial Sensitivity Tests
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Middle Aged
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Mutation
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Mycobacterium tuberculosis / drug effects*
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Mycobacterium tuberculosis / genetics
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Phylogeny
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Polymorphism, Single Nucleotide
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Public Health Surveillance
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Serbia / epidemiology
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Tuberculosis, Multidrug-Resistant / epidemiology*
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Tuberculosis, Multidrug-Resistant / microbiology*
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Tuberculosis, Multidrug-Resistant / transmission
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Young Adult