Multidrug-Resistant Mycobacterium tuberculosisof the Latin American Mediterranean Lineage, Wrongly Identified as Mycobacterium pinnipedii(Spoligotype International Type 863 [SIT863]), Causing Active Tuberculosis in South Brazil

Autor: Dalla Costa, Elis R., Vasconcelos, Sidra E. G., Esteves, Leonardo S., Gomes, Harrison M., Gomes, Lia L., Almeida da Silva, Pedro, Perdigão, João, Portugal, Isabel, Viveiros, Miguel, McNerney, Ruth, Pain, Arnab, Clark, Taane G., Rastogi, Nalin, Unis, Gisela, Rossetti, Maria Lucia R., Suffys, Philip Noel
Zdroj: Journal of Clinical Microbiology; August 2015, Vol. 53 Issue: 12 p3805-3811, 7p
Abstrakt: ABSTRACTWe recently detected the spoligotype patterns of strains of Mycobacterium pinnipedii, a species of the Mycobacterium tuberculosiscomplex, in sputum samples from nine cases with pulmonary tuberculosis residing in Porto Alegre, South Brazil. Because this species is rarely encountered in humans, we further characterized these nine isolates by additional genotyping techniques, including 24-locus mycobacterial interspersed repetitive-unit–variable-number tandem-repeat (MIRU-VNTR) typing, verification of the loci TbD1, RD9, pks15/1, RDRio, and fbpC, the insertion of IS6110at a site specific to the M. tuberculosisLatin American Mediterranean (LAM) lineage, and whole-genome sequencing. The combined analysis of these markers revealed that the isolates are in fact M. tuberculosisand more specifically belong to the LAM genotype. Most of these isolates (n= 8) were shown to be multidrug resistant (MDR), which prompted us to perform partial sequencing of the rpoA, rpoB, rpoC, katG, and inhAgenes. Seven isolates (77.8%) carried the S315T mutation in katG, and one of these (11%) also presented the C(-17)T single-nucleotide polymorphism (SNP) in inhA. Interestingly, six of the MDR isolates also presented an undescribed insertion of 12 nucleotides (CCA GAA CAA CCC) in codon 516 of rpoB. No putative compensatory mutation was found in either rpoAor rpoC. This is the first report of an M. tuberculosisLAM family strain with a convergent M. pinnipediispoligotype. These spoligotypes are observed in genotype databases at a modest frequency, highlighting that care must be taken when identifying isolates in the M. tuberculosiscomplex on the basis of single genetic markers.
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