The Association between Mycobacterium Tuberculosis Genotype and Drug Resistance in Peru.

The Association between Mycobacterium Tuberculosis Genotype and Drug Resistance in Peru.

<h4>Background</h4>The comparison of Mycobacterium tuberculosis bacterial genotypes with phenotypic, demographic, geospatial and clinical data improves our understanding of how strain lineage influences the development of drug-resistance and the spread of tuberculosis.<h4>Methods&l...

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Main Authors: Louis Grandjean, Tomotada Iwamoto, Anna Lithgow, Robert H Gilman, Kentaro Arikawa, Noriko Nakanishi, Laura Martin, Edith Castillo, Valentina Alarcon, Jorge Coronel, Walter Solano, Minoo Aminian, Claudia Guezala, Nalin Rastogi, David Couvin, Patricia Sheen, Mirko Zimic, David A J Moore
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0126271
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Summary:<h4>Background</h4>The comparison of Mycobacterium tuberculosis bacterial genotypes with phenotypic, demographic, geospatial and clinical data improves our understanding of how strain lineage influences the development of drug-resistance and the spread of tuberculosis.<h4>Methods</h4>To investigate the association of Mycobacterium tuberculosis bacterial genotype with drug-resistance. Drug susceptibility testing together with genotyping using both 15-loci MIRU-typing and spoligotyping, was performed on 2,139 culture positive isolates, each from a different patient in Lima, Peru. Demographic, geospatial and socio-economic data were collected using questionnaires, global positioning equipment and the latest national census.<h4>Results</h4>The Latin American Mediterranean (LAM) clade (OR 2.4, p<0.001) was significantly associated with drug-resistance and alone accounted for more than half of all drug resistance in the region. Previously treated patients, prisoners and genetically clustered cases were also significantly associated with drug-resistance (OR's 2.5, 2.4 and 1.8, p<0.001, p<0.05, p<0.001 respectively).<h4>Conclusions</h4>Tuberculosis disease caused by the LAM clade was more likely to be drug resistant independent of important clinical, genetic and socio-economic confounding factors. Explanations for this include; the preferential co-evolution of LAM strains in a Latin American population, a LAM strain bacterial genetic background that favors drug-resistance or the "founder effect" from pre-existing LAM strains disproportionately exposed to drugs.
ISSN:1932-6203

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