Beijing/W genotype Mycobacterium tuberculosis is widespread, may be increasing, and may have a predilection for drug resistance. Individual-level data on >29,000 patients from 49 studies in 35 countries were combined to assess the Beijing genotype's prevalence worldwide, trends over time and with age, and associations with drug resistance. We found 4 patterns for Beijing/W genotype tuberculosis (TB): 1) endemic, not associated with drug resistance (high level in most of East Asia, lower level in parts of the United States); 2) epidemic, associated with drug resistance (high level ...

<1% of TB cases were caused by Beijing genotype. In North America and the Caribbean, the proportion was higher (8%-14%). In the former Soviet Union the proportion was high: 45%-56% in Russia and 29% in Estonia. The proportion was low in India (1%), higher in Bangladesh (7%), and increased further east:><1% in a recent study from Tehran [11]). In Western Europe, Beijing genotype is more common among immigrant TB patients than among indigenous patients. The proportion of Beijing genotype TB among nonimmigrants may reflect the importance of immigrants to the total TB prevalence in these countries as well as the origin of these immigrants. Immigrants accounted for>