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Although multidrug-resistant tuberculosis (MDR-TB) remains a threat to TB control in Panama, few studies have focused in typing MDR-TB strains. The aim of our study was to characterize MDR <jats:italic>Mycobacterium tuberculosis<\/jats:italic> clinical isolates using PCR-based genetic markers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>From 2002 to 2004, a total of 231 <jats:italic>Mycobacterium tuberculosis<\/jats:italic> isolates from TB cases country-wide were screened for antibiotic resistance, and MDR-TB isolates were further genotyped by double repetitive element PCR (DRE-PCR), (GTG)5-PCR and spoligotyping.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 37 isolates (0.85%) were resistant to both isoniazid (INH) and rifampicin (RIF). Among these 37 isolates, only two (5.4%) were resistant to all five drugs tested. Dual genotyping using DRE-PCR and (GTG)5-PCR of MDR <jats:italic>Mycobacterium tuberculosis<\/jats:italic> isolates revealed eight clusters comprising 82.9% of the MDR-TB strain collection, and six isolates (17.1%) showed unique fingerprints. The spoligotyping of MDR-TB clinical isolates identified 68% as members of the 42 (LAM9) family genotype.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Our findings suggest that MDR <jats:italic>Mycobacterium tuberculosis<\/jats:italic> is highly clustered in Panama\u2019s metropolitan area corresponding to Panama City and Colon City, and our study reveals the genotype distribution across the country.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2334-13-442","type":"journal-article","created":{"date-parts":[[2013,9,23]],"date-time":"2013-09-23T05:03:59Z","timestamp":1379912639000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["High clustering rates of multidrug-resistant Mycobacterium tuberculosisgenotypes in Panama"],"prefix":"10.1186","volume":"13","author":[{"given":"Samantha","family":"Rosas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Bravo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franklin","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"de Moreno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Sanchez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronnie G","family":"Gavilan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amador","family":"Goodridge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,9,23]]},"reference":[{"key":"2652_CR1","volume-title":"Global tuberculosis report","author":"WHO","year":"2012","unstructured":"WHO: Global tuberculosis report. 2012, Geneve: Switzerland: World Health Organization"},{"key":"2652_CR2","volume-title":"Reporte nacional de tuberculosis","author":"MINSA","year":"2013","unstructured":"MINSA: Reporte nacional de tuberculosis. 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