Whole-genome sequencing reveals transmission pattern and drug resistance of Mycobacterium tuberculosis intra- or inter-hosts

BackgroundTuberculosis (TB) remains a serious global public health problem. The Mycobacterium tuberculosis (MTB) is responsible for approximately 10 million new TB cases globally each year. This study aimed to investigate transmission pattern and drug resistance of MTB in Shenzhen, China.MethodsA re...

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Main Authors: Feng Ding, Wanfei Liu, Chi Wu, Wensi Zhang, Shuyan Chen, Wenjie Lai, Jiayao Qu, Qiang Lin, Shuihua Lu, Jiuxin Qu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Cellular and Infection Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fcimb.2024.1488547/full
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author Feng Ding
Wanfei Liu
Chi Wu
Chi Wu
Wensi Zhang
Shuyan Chen
Shuyan Chen
Wenjie Lai
Wenjie Lai
Jiayao Qu
Jiayao Qu
Qiang Lin
Shuihua Lu
Jiuxin Qu
Jiuxin Qu
author_facet Feng Ding
Wanfei Liu
Chi Wu
Chi Wu
Wensi Zhang
Shuyan Chen
Shuyan Chen
Wenjie Lai
Wenjie Lai
Jiayao Qu
Jiayao Qu
Qiang Lin
Shuihua Lu
Jiuxin Qu
Jiuxin Qu
author_sort Feng Ding
collection DOAJ
description BackgroundTuberculosis (TB) remains a serious global public health problem. The Mycobacterium tuberculosis (MTB) is responsible for approximately 10 million new TB cases globally each year. This study aimed to investigate transmission pattern and drug resistance of MTB in Shenzhen, China.MethodsA retrospective study on 286 samples from 184 TB patients collected between 2015 and 2018 in Shenzhen Third People’s Hospital was conducted using whole-genome sequencing. Drug susceptibility testing (DST) was performed using both phenotypic DST (pDST) and molecular DST (mDST). Sample diversity was evaluated by SNPs and transmission clusters were identified based on SNP differences of 12 or fewer in genetic clusters.ResultsExcept four samples identified as non-tuberculous mycobacteria, 282 MTB samples (181 patients) underwent mDST, with 244 samples (162 patients) undergoing pDST. The overall multidrug-resistant rate in patients was 22.31% in pDST (12.00% for new patients and 40.82% for retreatment patients) and 34.48% in mDST (20.41% for new patients and 58.21% for retreatment patients). Totally 92 transmission clusters were identified, encompassing 70.21% samples (57.46% patients), with 5 clusters containing samples (15, 5.32%) from different patients (9, 4.97%), indicating recent transmission. The drug-resistant mutations in 36 of 45 transmission clusters (80.00%) were identical in all samples, suggesting the transmission of drug resistance. Patients with multiple samples were categorized into simultaneous sampling (SS) and continuous sampling (CS) groups, revealing significant differences in treatment types, treatment outcomes, residential addresses, and drug resistance types. mDST showed greater accuracy than pDST in SS and CS groups. A novel method based on heterozygous SNPs and two-sample Kolmogorov–Smirnov test were developed and identified 12 (4.26%) samples as mixed infection samples. Six of 12 patients had mixed and pure samples together, and major strains of mixed samples were closer to corresponding pure strains than minor strains.ConclusionsThis retrospective study, conducted at the only municipal hospital specializing in infectious diseases in Shenzhen, provides the opportunity to understand drug resistance of TB patients, which mainly are refractory patients. The study revealed transmission patterns of MTB, analyzed mixed infections, and tracked changes in MTB strains during short/long-term treatment.
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spelling doaj-art-5c0f0f66faae43c4bd216fb53b8bfa532025-01-21T05:43:18ZengFrontiers Media S.A.Frontiers in Cellular and Infection Microbiology2235-29882025-01-011410.3389/fcimb.2024.14885471488547Whole-genome sequencing reveals transmission pattern and drug resistance of Mycobacterium tuberculosis intra- or inter-hostsFeng Ding0Wanfei Liu1Chi Wu2Chi Wu3Wensi Zhang4Shuyan Chen5Shuyan Chen6Wenjie Lai7Wenjie Lai8Jiayao Qu9Jiayao Qu10Qiang Lin11Shuihua Lu12Jiuxin Qu13Jiuxin Qu14National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, ChinaShenzhen Branch, Guangdong Laboratory for Lingnan Modern Agriculture, Genome Analysis Laboratory of the Ministry of Agriculture and Rural Affairs, Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen, ChinaNational Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, ChinaDepartment of Clinical Laboratory, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, ChinaDepartment of Clinical Laboratory, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, ChinaNational Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, ChinaDepartment of Clinical Laboratory, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, ChinaNational Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, ChinaDepartment of Clinical Laboratory, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, ChinaNational Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, ChinaDepartment of Clinical Laboratory, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, ChinaShenzhen Branch, Guangdong Laboratory for Lingnan Modern Agriculture, Genome Analysis Laboratory of the Ministry of Agriculture and Rural Affairs, Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen, ChinaNational Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, ChinaNational Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, ChinaDepartment of Clinical Laboratory, Shenzhen Third People’s Hospital, The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, ChinaBackgroundTuberculosis (TB) remains a serious global public health problem. The Mycobacterium tuberculosis (MTB) is responsible for approximately 10 million new TB cases globally each year. This study aimed to investigate transmission pattern and drug resistance of MTB in Shenzhen, China.MethodsA retrospective study on 286 samples from 184 TB patients collected between 2015 and 2018 in Shenzhen Third People’s Hospital was conducted using whole-genome sequencing. Drug susceptibility testing (DST) was performed using both phenotypic DST (pDST) and molecular DST (mDST). Sample diversity was evaluated by SNPs and transmission clusters were identified based on SNP differences of 12 or fewer in genetic clusters.ResultsExcept four samples identified as non-tuberculous mycobacteria, 282 MTB samples (181 patients) underwent mDST, with 244 samples (162 patients) undergoing pDST. The overall multidrug-resistant rate in patients was 22.31% in pDST (12.00% for new patients and 40.82% for retreatment patients) and 34.48% in mDST (20.41% for new patients and 58.21% for retreatment patients). Totally 92 transmission clusters were identified, encompassing 70.21% samples (57.46% patients), with 5 clusters containing samples (15, 5.32%) from different patients (9, 4.97%), indicating recent transmission. The drug-resistant mutations in 36 of 45 transmission clusters (80.00%) were identical in all samples, suggesting the transmission of drug resistance. Patients with multiple samples were categorized into simultaneous sampling (SS) and continuous sampling (CS) groups, revealing significant differences in treatment types, treatment outcomes, residential addresses, and drug resistance types. mDST showed greater accuracy than pDST in SS and CS groups. A novel method based on heterozygous SNPs and two-sample Kolmogorov–Smirnov test were developed and identified 12 (4.26%) samples as mixed infection samples. Six of 12 patients had mixed and pure samples together, and major strains of mixed samples were closer to corresponding pure strains than minor strains.ConclusionsThis retrospective study, conducted at the only municipal hospital specializing in infectious diseases in Shenzhen, provides the opportunity to understand drug resistance of TB patients, which mainly are refractory patients. The study revealed transmission patterns of MTB, analyzed mixed infections, and tracked changes in MTB strains during short/long-term treatment.https://www.frontiersin.org/articles/10.3389/fcimb.2024.1488547/fullMycobacterium tuberculosistransmission patternwhole genome sequencingphenotypic DSTdrug resistant mutations
spellingShingle Feng Ding
Wanfei Liu
Chi Wu
Chi Wu
Wensi Zhang
Shuyan Chen
Shuyan Chen
Wenjie Lai
Wenjie Lai
Jiayao Qu
Jiayao Qu
Qiang Lin
Shuihua Lu
Jiuxin Qu
Jiuxin Qu
Whole-genome sequencing reveals transmission pattern and drug resistance of Mycobacterium tuberculosis intra- or inter-hosts
Frontiers in Cellular and Infection Microbiology
Mycobacterium tuberculosis
transmission pattern
whole genome sequencing
phenotypic DST
drug resistant mutations
title Whole-genome sequencing reveals transmission pattern and drug resistance of Mycobacterium tuberculosis intra- or inter-hosts
title_full Whole-genome sequencing reveals transmission pattern and drug resistance of Mycobacterium tuberculosis intra- or inter-hosts
title_fullStr Whole-genome sequencing reveals transmission pattern and drug resistance of Mycobacterium tuberculosis intra- or inter-hosts
title_full_unstemmed Whole-genome sequencing reveals transmission pattern and drug resistance of Mycobacterium tuberculosis intra- or inter-hosts
title_short Whole-genome sequencing reveals transmission pattern and drug resistance of Mycobacterium tuberculosis intra- or inter-hosts
title_sort whole genome sequencing reveals transmission pattern and drug resistance of mycobacterium tuberculosis intra or inter hosts
topic Mycobacterium tuberculosis
transmission pattern
whole genome sequencing
phenotypic DST
drug resistant mutations
url https://www.frontiersin.org/articles/10.3389/fcimb.2024.1488547/full
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