{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:20:11Z","timestamp":1778545211414,"version":"3.51.4"},"reference-count":57,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,5]]},"abstract":"<jats:p>Vietnam has a high burden of tuberculosis (TB) and multidrug-resistant (MDR) TB, but drug resistance patterns and TB transmission dynamics among TB\/human immunodeficiency virus (HIV) coinfected patients are not well described. We characterized 200 <jats:italic>Mycobacterium tuberculosis<\/jats:italic> isolates from TB\/HIV coinfected patients diagnosed at the main TB referral hospital in Ho Chi Minh City, Vietnam. Phenotypic drug susceptibility testing (DST) for first-line drugs, spoligotyping, and 24-locus mycobacterial interspersed repetitive unit (MIRU-24) analysis was performed on all isolates. The 24-locus mycobacterial interspersed repetitive unit clusters and MDR isolates were subjected to whole genome sequencing (WGS). Most of the TB\/HIV coinfected patients were young (162\/174; 93.1% aged &lt; 45 years) males (173; 86.5% male). Beijing (98; 49.0%) and Indo-Oceanic (70; 35.0%) lineage strains were most common. Phenotypic drug resistance was detected in 84 (42.0%) isolates, of which 17 (8.5%) were MDR; three additional MDR strains were identified on WGS. Strain clustering was reduced from 84.0% with spoligotyping to 20.0% with MIRU-24 typing and to 13.5% with WGS. Whole genome sequencing identified five additional clusters, or members of clusters, not recognized by MIRU-24. In total, 13 small (two to three member) WGS clusters were identified, with less clustering among drug susceptible (2\/27; 7.4%) than among drug-resistant strains (25\/27; 92.6%). On phylogenetic analysis, strains from TB\/HIV coinfected patients were interspersed among strains from the general community; no major clusters indicating transmission among people living with HIV were detected. Tuberculosis\/HIV coinfection in Vietnam was associated with high rates of drug resistance and limited genomic evidence of ongoing <jats:italic>M. tuberculosis<\/jats:italic> transmission among HIV-infected patients.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0185","type":"journal-article","created":{"date-parts":[[2018,10,30]],"date-time":"2018-10-30T07:08:44Z","timestamp":1540883324000},"page":"1397-1406","source":"Crossref","is-referenced-by-count":14,"title":["Mycobacterium tuberculosis Drug Resistance and Transmission among Human Immunodeficiency Virus\u2013Infected Patients in Ho Chi Minh City, Vietnam"],"prefix":"10.4269","volume":"99","author":[{"given":"Trinh Quynh","family":"Mai","sequence":"first","affiliation":[{"name":"National Institute of Hygiene and Epidemiology, Hanoi, Vietnam;"},{"name":"Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia;"},{"name":"Centre for Infectious Disease and Microbiology\u2014Public Health, ICPMR, Westmead Hospital, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Martinez","sequence":"additional","affiliation":[{"name":"Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia;"},{"name":"Centre for Infectious Disease and Microbiology\u2014Public Health, ICPMR, Westmead Hospital, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranjeeta","family":"Menon","sequence":"additional","affiliation":[{"name":"Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia;"},{"name":"Centre for Infectious Disease and Microbiology\u2014Public Health, ICPMR, Westmead Hospital, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nguyen Thi","family":"Van Anh","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology, Hanoi, Vietnam;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nguyen Tran","family":"Hien","sequence":"additional","affiliation":[{"name":"National Institute of Hygiene and Epidemiology, Hanoi, Vietnam;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben J.","family":"Marais","sequence":"additional","affiliation":[{"name":"Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vitali","family":"Sintchenko","sequence":"additional","affiliation":[{"name":"Sydney Medical School and Marie Bashir Institute for Infectious Diseases and Biosecurity, The University of Sydney, Sydney, Australia;"},{"name":"Centre for Infectious Disease and Microbiology\u2014Public Health, ICPMR, Westmead Hospital, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","author":"World Health Organization","year":"2017"},{"key":"b2","series-title":"Lancet Infect Dis","first-page":"529","article-title":"Drug-resistant tuberculosis: time for visionary political leadership","volume":"13","author":"Abubakar","year":"2013"},{"key":"b3","series-title":"Int J Infect Dis","first-page":"14","article-title":"The risk of global epidemic replacement with drug-resistant Mycobacterium tuberculosis strains","volume":"56","author":"McBryde","year":"2017"},{"key":"b4","series-title":"Int J Tuberc Lung Dis","first-page":"1320","article-title":"Mechanisms of drug resistance in Mycobacterium tuberculosis","volume":"13","author":"Zhang","year":"2009"},{"key":"b5","series-title":"N Engl J Med","first-page":"2161","article-title":"National survey of drug-resistant tuberculosis in China","volume":"366","author":"Zhao","year":"2012"},{"key":"b6","series-title":"BMC Infect Dis","first-page":"36","article-title":"High rates of multidrug-resistant and rifampicin-resistant tuberculosis among re-treatment cases: where do they come from?","volume":"17","author":"Ragonnet","year":"2017"},{"key":"b7","series-title":"J Clin Microbiol","first-page":"1818","article-title":"Epidemic spread of multidrug-resistant tuberculosis in Johannesburg, South Africa","volume":"51","author":"Marais","year":"2013"},{"key":"b8","series-title":"Lancet","first-page":"1575","article-title":"Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa","volume":"368","author":"Gandhi","year":"2006"},{"key":"b9","series-title":"Lancet","first-page":"1902","article-title":"Scaling up interventions to achieve global tuberculosis control: progress and new developments","volume":"379","author":"Raviglione","year":"2012"},{"key":"b10","author":"Vietnam National Tuberculosis Control Program, Ministry of Health","year":"2015"},{"key":"b11","series-title":"Int J Tuberc Lung Dis","first-page":"969","article-title":"Treatment outcomes for HIV and MDR-TB co-infected adults and children: systematic review and meta-analysis","volume":"19","author":"Isaakidis","year":"2015"},{"key":"b12","series-title":"Lancet","first-page":"1500","article-title":"Prevention of nosocomial transmission of extensively drug-resistant tuberculosis in rural South African district hospitals: an epidemiological modelling study","volume":"370","author":"Basu","year":"2007"},{"key":"b13","series-title":"J Glob Antimicrob Resist","first-page":"154","article-title":"Drug resistance and Mycobacterium tuberculosis strain diversity in TB\/HIV co-infected patients in Ho Chi Minh city, Vietnam","volume":"10","author":"Mai","year":"2017"},{"key":"b14","series-title":"BMC Infect Dis","first-page":"455","article-title":"Temporal dynamics of Mycobacterium tuberculosis genotypes in New South Wales, Australia","volume":"14","author":"Gurjav","year":"2014"},{"key":"b15","series-title":"PLoS One","first-page":"e0163612","article-title":"Whole genome sequencing demonstrates limited transmission within identified Mycobacterium tuberculosis clusters in New South Wales, Australia","volume":"11","author":"Gurjav","year":"2016"},{"key":"b16","series-title":"Lancet Infect Dis.","first-page":"328","article-title":"Global phylogeography of Mycobacterium tuberculosis and implications for tuberculosis product development","volume":"7","author":"Gagneux","year":"2007"},{"key":"b17","series-title":"Nat Genet","first-page":"849","article-title":"Frequent transmission of the Mycobacterium tuberculosis Beijing lineage and positive selection for the EsxW Beijing variant in Vietnam","volume":"50","author":"Holt","year":"2018"},{"key":"b18","author":"Pham Ngoc Thach TB and Lung Disease Hospital","year":"2016"},{"key":"b19","series-title":"J Clin Microbiol","first-page":"2333","article-title":"Mutations prevalent among rifampin- and isoniazid-resistant Mycobacterium tuberculosis isolates from a hospital in Vietnam","volume":"44","author":"Caws","year":"2006"},{"key":"b20","author":"Abdel Aziz","year":"2003"},{"key":"b21","series-title":"J Clin Microbiol","first-page":"907","article-title":"Simultaneous detection and strain differentiation of Mycobacterium tuberculosis for diagnosis and epidemiology","volume":"35","author":"Kamerbeek","year":"1997"},{"key":"b22","series-title":"J Clin Microbiol","first-page":"4498","article-title":"Proposal for standardization of optimized mycobacterial interspersed repetitive unit-variable-number tandem repeat typing of Mycobacterium tuberculosis","volume":"44","author":"Supply","year":"2006"},{"key":"b23","series-title":"Lancet Respir Med","first-page":"49","article-title":"Rapid, comprehensive, and affordable mycobacterial diagnosis with whole-genome sequencing: a prospective study","volume":"4","author":"Pankhurst","year":"2016"},{"key":"b24","series-title":"PLoS One","first-page":"e9490","article-title":"FastTree 2\u2014approximately maximum-likelihood trees for large alignments","volume":"5","author":"Price","year":"2010"},{"key":"b25","author":"Wickham","year":"2009"},{"key":"b26","series-title":"PLoS One","first-page":"e90868","article-title":"High rates of potentially infectious tuberculosis and multidrug-resistant tuberculosis (MDR-TB) among hospital inpatients in KwaZulu Natal, South Africa indicate risk of nosocomial transmission","volume":"9","author":"Bantubani","year":"2014"},{"key":"b27","series-title":"J Clin Microbiol","first-page":"3795","article-title":"Whole-genome sequencing of the Mycobacterium tuberculosis Manila sublineage results in less clustering and better resolution than mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing and spoligotyping","volume":"52","author":"Jamieson","year":"2014"},{"key":"b28","series-title":"Mol Biol Evol","first-page":"2472","article-title":"Timing and order of transmission events is not directly reflected in a pathogen phylogeny","volume":"31","author":"Romero-Severson","year":"2014"},{"key":"b29","series-title":"Western Pac Surveill Response J","first-page":"7","article-title":"Tuberculosis case notification data in Viet Nam, 2007 to 2012","volume":"6","author":"Nhung","year":"2015"},{"key":"b30","series-title":"PLoS One","first-page":"e0149806","article-title":"The burden of drug-resistant tuberculosis in Papua New Guinea: results of a large population-based survey","volume":"11","author":"Aia","year":"2016"},{"key":"b31","series-title":"Int J Tuberc Lung Dis","first-page":"297","article-title":"Latent tuberculous infection in household contacts of multidrug-resistant and newly diagnosed tuberculosis","volume":"21","author":"Fox","year":"2017"},{"key":"b32","series-title":"Int J Tuberc Lung Dis","first-page":"527","article-title":"Association of streptomycin resistance mutations with level of drug resistance and Mycobacterium tuberculosis genotypes","volume":"16","author":"Nhu","year":"2012"},{"key":"b33","series-title":"Int J Tuberc Lung Dis","first-page":"160","article-title":"Drug resistance among smear-positive tuberculosis patients in Ho Chi Minh City, Vietnam","volume":"10","author":"Quy","year":"2006"},{"key":"b34","series-title":"Tuberculosis (Edinb)","first-page":"49","article-title":"Transmission of multi-drug resistant tuberculosis in Mongolia is driven by Beijing strains of Mycobacterium tuberculosis resistant to all first-line drugs","volume":"101","author":"Gurjav","year":"2016"},{"key":"b35","series-title":"PLoS One","first-page":"e71867","article-title":"Primary drug-resistant tuberculosis in Hanoi, Viet Nam: present status and risk factors","volume":"8","author":"Hang","year":"2013"},{"key":"b36","series-title":"J Antimicrob Chemother","first-page":"2341","article-title":"Characterization of mutations in streptomycin-resistant Mycobacterium tuberculosis clinical isolates in the area of Barcelona","volume":"65","author":"Tudo","year":"2010"},{"key":"b37","series-title":"J Glob Antimicrob Resist","first-page":"5","article-title":"Mutations in rrs, rpsL and gidB in streptomycin-resistant Mycobacterium tuberculosis isolates from Thailand","volume":"4","author":"Smittipat","year":"2016"},{"key":"b38","series-title":"Nat Genet","first-page":"307","article-title":"Genome-wide analysis of multi- and extensively drug-resistant Mycobacterium tuberculosis","volume":"50","author":"Coll","year":"2018"},{"key":"b39","series-title":"PLoS One","first-page":"e0153563","article-title":"Discordance across phenotypic and molecular methods for drug susceptibility testing of drug-resistant Mycobacterium tuberculosis isolates in a low TB incidence country","volume":"11","author":"Ahmad","year":"2016"},{"key":"b40","series-title":"J Clin Microbiol","first-page":"20","article-title":"Current perspectives on drug susceptibility testing of Mycobacterium tuberculosis complex: the automated nonradiometric systems","volume":"44","author":"Piersimoni","year":"2006"},{"key":"b41","series-title":"J Clin Microbiol","first-page":"1871","article-title":"Comprehensive whole-genome sequencing and reporting of drug resistance profiles on clinical cases of Mycobacterium tuberculosis in New York state","volume":"55","author":"Shea","year":"2017"},{"key":"b42","series-title":"J Clin Microbiol","first-page":"2633","article-title":"Rifampin drug resistance tests for tuberculosis: challenging the gold standard","volume":"51","author":"Van Deun","year":"2013"},{"key":"b43","series-title":"Sci Rep","first-page":"46327","article-title":"Mycobacterium tuberculosis resistance prediction and lineage classification from genome sequencing: comparison of automated analysis tools","volume":"7","author":"Schleusener","year":"2017"},{"key":"b44","series-title":"Int J Tuberc Lung Dis","first-page":"1276","article-title":"Mechanisms of drug resistance in Mycobacterium tuberculosis: update 2015","volume":"19","author":"Zhang","year":"2015"},{"key":"b45","series-title":"MBio","first-page":"e00812","article-title":"The new Xpert MTB\/RIF Ultra: improving detection of Mycobacterium tuberculosis and resistance to rifampin in an assay suitable for point-of-care testing","volume":"8","author":"Chakravorty","year":"2017"},{"key":"b46","series-title":"Lancet Infect Dis","first-page":"1193","article-title":"Whole-genome sequencing for prediction of Mycobacterium tuberculosis drug susceptibility and resistance: a retrospective cohort study","volume":"15","author":"Walker","year":"2015"},{"key":"b47","series-title":"N Engl J Med","first-page":"1181","article-title":"Detection of drug-resistant tuberculosis by Xpert MTB\/RIF in Swaziland","volume":"372","author":"Sanchez-Padilla","year":"2015"},{"key":"b48","series-title":"Int J Tuberc Lung Dis","first-page":"116","article-title":"Drug susceptibility testing proficiency in the network of supranational tuberculosis reference laboratories","volume":"15","author":"Van Deun","year":"2011"},{"key":"b49","series-title":"Eur Respir J","first-page":"564","article-title":"Drug-susceptibility testing in tuberculosis: methods and reliability of results","volume":"25","author":"Kim","year":"2005"},{"key":"b50","series-title":"Int J Tuberc Lung Dis","first-page":"1142","article-title":"Proficiency of drug susceptibility testing for Mycobacterium tuberculosis in Taiwan","volume":"13","author":"Jou","year":"2009"},{"key":"b51","series-title":"Antimicrob Agents Chemother","first-page":"4515","article-title":"Lack of correlation between embB mutation and ethambutol MIC in Mycobacterium tuberculosis clinical isolates from China","volume":"51","author":"Shi","year":"2007"},{"key":"b52","series-title":"Antimicrob Agents Chemother","first-page":"4498","article-title":"Fluoroquinolone resistance in Mycobacterium tuberculosis and mutations in gyrA and gyrB","volume":"53","author":"Von Groll","year":"2009"},{"key":"b53","series-title":"Emerg Microbes Infect","first-page":"e19","article-title":"Association of gyrA\/B mutations and resistance levels to fluoroquinolones in clinical isolates of Mycobacterium tuberculosis","volume":"3","author":"Li","year":"2014"},{"key":"b54","series-title":"Int J Infect Dis","first-page":"14","article-title":"Community-acquired pneumonia and tuberculosis: differential diagnosis and the use of fluoroquinolones","volume":"18","author":"Grossman","year":"2014"},{"key":"b55","series-title":"Int J Tuberc Lung Dis","first-page":"77","article-title":"Use of fluoroquinolone antibiotics leads to tuberculosis treatment delay in a South African gold mining community","volume":"15","author":"Jeon","year":"2011"},{"key":"b56","series-title":"Int J Infect Dis","first-page":"56","article-title":"Tuberculosis and HIV co-infection in Vietnam","volume":"46","author":"Trinh","year":"2016"},{"key":"b57","series-title":"J Int AIDS Soc","first-page":"19408","article-title":"Adolescent girls and young women: key populations for HIV epidemic control","volume":"18","author":"Dellar","year":"2015"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/99\/6\/article-p1397.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/99\/6\/article-p1397.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/99\/6\/article-p1397.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T20:35:46Z","timestamp":1722458146000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/99\/6\/article-p1397.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,5]]},"references-count":57,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.18-0185","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,5]]}}}