Genetic diversity of Mycobacterium tuberculosis in Peru and exploration of phylogenetic associations with drug resistance.
<h4>Background</h4>There is limited available data on the strain diversity of M tuberculosis in Peru, though there may be interesting lessons to learn from a setting where multidrug resistant TB has emerged as a major problem despite an apparently well-functioning DOTS control programme....
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2013-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0065873&type=printable |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849434050545057792 |
|---|---|
| author | Patricia Sheen David Couvin Louis Grandjean Mirko Zimic Maria Dominguez Giannina Luna Robert H Gilman Nalin Rastogi David A J Moore |
| author_facet | Patricia Sheen David Couvin Louis Grandjean Mirko Zimic Maria Dominguez Giannina Luna Robert H Gilman Nalin Rastogi David A J Moore |
| author_sort | Patricia Sheen |
| collection | DOAJ |
| description | <h4>Background</h4>There is limited available data on the strain diversity of M tuberculosis in Peru, though there may be interesting lessons to learn from a setting where multidrug resistant TB has emerged as a major problem despite an apparently well-functioning DOTS control programme.<h4>Methods</h4>Spoligotyping was undertaken on 794 strains of M tuberculosis collected between 1999 and 2005 from 553 community-based patients and 241 hospital-based HIV co-infected patients with pulmonary tuberculosis in Lima, Peru. Phylogenetic and epidemiologic analyses permitted identification of clusters and exploration of spoligotype associations with drug resistance.<h4>Results</h4>Mean patient age was 31.9 years, 63% were male and 30.4% were known to be HIV+. Rifampicin mono-resistance, isoniazid mono-resistance and multidrug resistance (MDR) were identified in 4.7%, 8.7% and 17.3% of strains respectively. Of 794 strains from 794 patients there were 149 different spoligotypes. Of these there were 27 strains (3.4%) with novel, unique orphan spoligotypes. 498 strains (62.7%) were clustered in the nine most common spoligotypes: 16.4% SIT 50 (clade H3), 12.3% SIT 53 (clade T1), 8.3% SIT 33 (LAM3), 7.4% SIT 42 (LAM9), 5.5% SIT 1 (Beijing), 3.9% SIT 47 (H1), 3.0% SIT 222 (clade unknown), 3.0% SIT1355 (LAM), and 2.8% SIT 92 (X3). Amongst HIV-negative community-based TB patients no associations were seen between drug resistance and specific spoligotypes; in contrast HIV-associated MDRTB, but not isoniazid or rifampicin mono-resistance, was associated with SIT42 and SIT53 strains.<h4>Conclusion</h4>Two spoligotypes were associated with MDR particularly amongst patients with HIV. The MDR-HIV association was significantly reduced after controlling for SIT42 and SIT53 status; residual confounding may explain the remaining apparent association. These data are suggestive of a prolonged, clonal, hospital-based outbreak of MDR disease amongst HIV patients but do not support a hypothesis of strain-specific propensity for the acquisition of resistance-conferring mutations. |
| format | Article |
| id | doaj-art-5544b8cb3a464db5be6aa94d48a54bef |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-5544b8cb3a464db5be6aa94d48a54bef2025-08-20T03:26:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0186e6587310.1371/journal.pone.0065873Genetic diversity of Mycobacterium tuberculosis in Peru and exploration of phylogenetic associations with drug resistance.Patricia SheenDavid CouvinLouis GrandjeanMirko ZimicMaria DominguezGiannina LunaRobert H GilmanNalin RastogiDavid A J Moore<h4>Background</h4>There is limited available data on the strain diversity of M tuberculosis in Peru, though there may be interesting lessons to learn from a setting where multidrug resistant TB has emerged as a major problem despite an apparently well-functioning DOTS control programme.<h4>Methods</h4>Spoligotyping was undertaken on 794 strains of M tuberculosis collected between 1999 and 2005 from 553 community-based patients and 241 hospital-based HIV co-infected patients with pulmonary tuberculosis in Lima, Peru. Phylogenetic and epidemiologic analyses permitted identification of clusters and exploration of spoligotype associations with drug resistance.<h4>Results</h4>Mean patient age was 31.9 years, 63% were male and 30.4% were known to be HIV+. Rifampicin mono-resistance, isoniazid mono-resistance and multidrug resistance (MDR) were identified in 4.7%, 8.7% and 17.3% of strains respectively. Of 794 strains from 794 patients there were 149 different spoligotypes. Of these there were 27 strains (3.4%) with novel, unique orphan spoligotypes. 498 strains (62.7%) were clustered in the nine most common spoligotypes: 16.4% SIT 50 (clade H3), 12.3% SIT 53 (clade T1), 8.3% SIT 33 (LAM3), 7.4% SIT 42 (LAM9), 5.5% SIT 1 (Beijing), 3.9% SIT 47 (H1), 3.0% SIT 222 (clade unknown), 3.0% SIT1355 (LAM), and 2.8% SIT 92 (X3). Amongst HIV-negative community-based TB patients no associations were seen between drug resistance and specific spoligotypes; in contrast HIV-associated MDRTB, but not isoniazid or rifampicin mono-resistance, was associated with SIT42 and SIT53 strains.<h4>Conclusion</h4>Two spoligotypes were associated with MDR particularly amongst patients with HIV. The MDR-HIV association was significantly reduced after controlling for SIT42 and SIT53 status; residual confounding may explain the remaining apparent association. These data are suggestive of a prolonged, clonal, hospital-based outbreak of MDR disease amongst HIV patients but do not support a hypothesis of strain-specific propensity for the acquisition of resistance-conferring mutations.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0065873&type=printable |
| spellingShingle | Patricia Sheen David Couvin Louis Grandjean Mirko Zimic Maria Dominguez Giannina Luna Robert H Gilman Nalin Rastogi David A J Moore Genetic diversity of Mycobacterium tuberculosis in Peru and exploration of phylogenetic associations with drug resistance. PLoS ONE |
| title | Genetic diversity of Mycobacterium tuberculosis in Peru and exploration of phylogenetic associations with drug resistance. |
| title_full | Genetic diversity of Mycobacterium tuberculosis in Peru and exploration of phylogenetic associations with drug resistance. |
| title_fullStr | Genetic diversity of Mycobacterium tuberculosis in Peru and exploration of phylogenetic associations with drug resistance. |
| title_full_unstemmed | Genetic diversity of Mycobacterium tuberculosis in Peru and exploration of phylogenetic associations with drug resistance. |
| title_short | Genetic diversity of Mycobacterium tuberculosis in Peru and exploration of phylogenetic associations with drug resistance. |
| title_sort | genetic diversity of mycobacterium tuberculosis in peru and exploration of phylogenetic associations with drug resistance |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0065873&type=printable |
| work_keys_str_mv | AT patriciasheen geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance AT davidcouvin geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance AT louisgrandjean geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance AT mirkozimic geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance AT mariadominguez geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance AT gianninaluna geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance AT roberthgilman geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance AT nalinrastogi geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance AT davidajmoore geneticdiversityofmycobacteriumtuberculosisinperuandexplorationofphylogeneticassociationswithdrugresistance |