{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:46:09Z","timestamp":1779331569864,"version":"3.51.4"},"reference-count":40,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2015,2,1]],"date-time":"2015-02-01T00:00:00Z","timestamp":1422748800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The emergence and transmission of extensively drug-resistant tuberculosis (XDR-TB) pose an increasing threat to global TB control. This study aimed to identify the patterns of evolution and transmission dynamics of XDR-TB in populations in a region of China where TB is highly endemic. We analyzed a total of 95 XDR-TB isolates collected from 2003 to 2009 in Chongqing, China. Eight drug resistance genes covering 7 drugs that define XDR-TB were amplified by PCR followed by DNA sequencing. Variable-number tandem repeat 16-locus (VNTR-16) genotyping and genotypic drug resistance profiles were used to determine the evolution or transmission patterns of XDR-TB strains. Our results indicated that the Beijing genotype was predominant (85\/95 [89.5%]) in XDR-TB strains, and as many as 40.0% (38\/95) of the isolates were distributed into 6 clusters based on VNTR-16 genotyping and drug resistance mutation profiles. All isolates of each cluster harbored as many as six identical resistance mutations in the drug resistance genes\n            <jats:italic>rpoB<\/jats:italic>\n            ,\n            <jats:italic>katG<\/jats:italic>\n            ,\n            <jats:italic>inhA<\/jats:italic>\n            promoter,\n            <jats:italic>embB<\/jats:italic>\n            ,\n            <jats:italic>rpsL<\/jats:italic>\n            , and\n            <jats:italic>gidB<\/jats:italic>\n            . Among the nine cases with continuous isolates from multidrug-resistant (MDR) to XDR-TB, 4 cases represented acquired drug resistance, 4 cases were caused by transmission, and 1 case was due to exogenous superinfection. The XDR-TB epidemic in China is mainly caused by a high degree of clonal transmission, but evolution from MDR to XDR and even superinfection with a new XDR strain can also occur.\n          <\/jats:p>","DOI":"10.1128\/aac.03504-14","type":"journal-article","created":{"date-parts":[[2014,11,18]],"date-time":"2014-11-18T05:07:10Z","timestamp":1416287230000},"page":"818-825","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":14,"title":["Evolution and Transmission Patterns of Extensively Drug-Resistant Tuberculosis in China"],"prefix":"10.1128","volume":"59","author":[{"given":"Feifei","family":"Wang","sequence":"first","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"},{"name":"Department of Medical Microbiology and Parasitology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingyun","family":"Shao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoping","family":"Fan","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaojie","family":"Shen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ni","family":"Diao","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jialin","family":"Jin","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Sun","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Wu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiazhen","family":"Chen","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinhua","family":"Weng","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xunjia","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"},{"name":"Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Medical Molecular Virology, Huashan Hospital, Fudan University, Shanghai, China"},{"name":"Institute of Biomedical Sciences, Shanghai Medical College, Fudan University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60410-2"},{"key":"e_1_3_3_3_2","first-page":"301","article-title":"Emergence of Mycobacterium tuberculosis with extensive resistance to second-line drugs-worldwide, 2000\u20132004","volume":"55","author":"Centers for Disease Control and Prevention","year":"2006","unstructured":"Centers for Disease Control and Prevention. 2006. 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