Discrepancy in the transmissibility of multidrug-resistant mycobacterium tuberculosis in urban and rural areas in China.

Autor:	Li M; Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Science, Shanghai Medical College, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People's Republic of China.; National Clinical Research Center for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, People's Republic of China., Lu L; Department of Tuberculosis Control, Songjiang District Center for Disease Control and Prevention, Shanghai, People's Republic of China., Guo M; Department of Tuberculosis Control, Wusheng County Center for Disease Control and Prevention, Guang'an, People's Republic of China., Jiang Q; School of Public Health, Renmin Hospital Public Health Research Institute, Wuhan University, Wuhan, People's Republic of China., Xia L; Sichuan Provincial Center for Disease Control and Prevention, Institution for Tuberculosis Prevention and Control, Chengdu, People's Republic of China., Jiang Y; Tuberculosis Laboratory, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China., Zhang S; Sichuan Provincial Center for Disease Control and Prevention, Institution for Tuberculosis Prevention and Control, Chengdu, People's Republic of China., Qiu Y; Department of Tuberculosis Control, Wusheng County Center for Disease Control and Prevention, Guang'an, People's Republic of China., Yang C; Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Science, Shanghai Medical College, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People's Republic of China.; School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, People's Republic of China., Chen Y; Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Science, Shanghai Medical College, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People's Republic of China.; National Clinical Research Center for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, People's Republic of China., Hong J; Department of Tuberculosis Control, Songjiang District Center for Disease Control and Prevention, Shanghai, People's Republic of China., Guo X; Department of Tuberculosis Control, Songjiang District Center for Disease Control and Prevention, Shanghai, People's Republic of China., Takiff H; Laboratorio de Genética Molecular, CMBC, IVIC, Caracas, Venezuela., Shen X; Tuberculosis Laboratory, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, People's Republic of China., Chen C; Sichuan Provincial Center for Disease Control and Prevention, Institution for Tuberculosis Prevention and Control, Chengdu, People's Republic of China., Gao Q; Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Science, Shanghai Medical College, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, People's Republic of China.; National Clinical Research Center for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, People's Republic of China.
Jazyk:	angličtina
Zdroj:	Emerging microbes & infections [Emerg Microbes Infect] 2023 Dec; Vol. 12 (1), pp. 2192301.
DOI:	10.1080/22221751.2023.2192301
Abstrakt:	The fitness of multidrug-resistant tuberculosis (MDR-TB) is thought to be an important determinant of a strain's ability to be transmitted. Studies in the laboratory have demonstrated that MDR-TB strains have reduced fitness but the relative transmissibility of MDR-TB versus drug-susceptible (DS) TB strains in human populations remains unresolved. We used data on genomic clustering from our previous molecular epidemiological study in Songjiang (2011-2020) and Wusheng (2009-2020), China, to compare the relative transmissibility of MDR-TB versus DS-TB. Genomic clusters were defined with a threshold distance of 12-single-nucleotide-polymorphisms and the risk for MDR-TB clustering was analyzed by logistic regression. In total, 2212 culture-positive pulmonary TB patients were enrolled in Songjiang and 1289 in Wusheng. The clustering rates of MDR-TB and DS-TB strains were 19.4% (20/103) and 26.3% (509/1936), respectively in Songjiang, and 43.9% (29/66) and 26.0% (293/1128) in Wusheng. The risk of MDR-TB clustering was 2.34 (95% CI 1.38-3.94) times higher than DS-TB clustering in Wusheng and 0.64 (95% CI 0.38-1.06) times lower in Songjiang. Neither lineage 2, compensatory mutations nor rpoB S450L were significantly associated with MDR-TB transmission, and katG S315 T increased MDR-TB transmission only in Wusheng (OR 5.28, 95% CI 1.42-19.21). MDR-TB was not more transmissible than DS-TB in either Songjiang or Wusheng. It appears that the different transmissibility of MDR-TB in Songjiang and Wusheng is likely due to differences in the quality of the local TB control programmes. Suggesting that the most effective way to control MDR-TB is by improving local TB control programmes.
Databáze:	MEDLINE
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