Multi-drug resistant Mycobacterium tuberculosis complex genetic diversity and clues on recent transmission in Punjab, Pakistan
| Autor: | Guislaine Refrégier, Michel K. Gomgnimbou, Christophe Sola, Memona Yasmin, Rubina Tabassum Siddiqui |
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| Rok vydání: | 2014 |
| Předmět: |
Microbiology (medical)
Genotype Antitubercular Agents Microbial Sensitivity Tests Minisatellite Repeats Biology Microbiology Mycobacterium tuberculosis Drug Resistance Multiple Bacterial Tuberculosis Multidrug-Resistant Genetics medicine Cluster Analysis Humans Pakistan Molecular Biology Genotyping Ecology Evolution Behavior and Systematics Genetic diversity Molecular epidemiology Geography Genetic Variation biology.organism_classification Virology Infectious Diseases Mycobacterium tuberculosis complex Mutation Multilocus sequence typing Rifampicin medicine.drug Multilocus Sequence Typing |
| Zdroj: | Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases. 27 |
| ISSN: | 1567-7257 |
| Popis: | Multi-Drug Resistant Tuberculosis (MDR-TB), i.e. bacilli resistant to rifampicin (RIF) and isoniazid (INH), is a major Public Health concern in Pakistan according to WHO estimates (3.5% and 32% of new and retreated cases, respectively). Previous Pakistanis reports identified a correlation between being MDR and belonging to Beijing or EAI lineages in one study, and belonging to "H4"-Ural Euro-American sublineage in another study. In addition, MDR-TB transmission was suspected in Karachi. We tested MDR characteristics on a Punjab sample of 278 clinical isolates (without selection for Multi-Drug Resistance) including new and retreated cases collected from 2008 to 2012. All samples were characterized by a new, microbead-based method named "TB-SPRINT" (molecular diagnostic including spoligotype identification, and genetic resistance determinants to first-line anti-TB drugs RIF and INH). Isolates from 2011 to 2012 (n=100) were further analyzed using 24-loci MIRU-VNTR. We detected 8.7% MDR isolates (CI95%=[5.0; 12.5]), mainly among CAS lineage that predominates in this central-East region of Pakistan. Out of 20 MDR-TB cases, 12 different TB-SPRINT profiles were identified, limiting the suspicion of MDR-TB transmission. 24 MIRU-VNTR confirmed the unrelatedness of isolates with different TB-SPRINT profiles and discriminated 3 isolates with identical TB-SPRINT profiles. In conclusion, our study did not confirm any of the correlations between Multi-Drug Resistance and lineage or sublineage in Punjab, Pakistan. MDR-TB isolates were diverse indicating that transmission is not pervasive. TB-SPRINT proved useful as a first step for detecting MDR-TB likely transmission events, before more extensive genotyping such as 15 or 24 MIRU-VNTR and thorough epidemiological investigation. |
| Databáze: | OpenAIRE |
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