Abstract
The purpose of this study was to increase our knowledge about Mycobacterium africanum and report the incidence and characteristics of tuberculosis (TB) due to their lineages in Aragon, Spain, over the period 2003–2019. The study includes all the cases in our region, where all the M. tuberculosis complex isolates are systematically characterised. We detected 31 cases of M. africanum among 2598 cases of TB in the period studied. TB caused by M. africanum is rare (1.19%) in our population, and it affects mainly men of economically productive age coming from West African countries. Among the isolates, Lineage (L) 6 was more frequent than L5. The genotyping of these strains identified five clusters and 13 strains with a unique pattern. The isolates’ characterisation identified a copy of IS6110 within the moaX gene, which turned out to be specific for L6. It will allow the differentiation of this lineage from the rest of MTBC with a simple PCR reaction. It remains to be established whether this polymorphism may limit M. africanum transmission. Furthermore, a mutation in the mutT2 promoter was found as specific for L6 strains, which could be related to the high variability found for L6 compared to L5.
Highlights
The purpose of this study was to increase our knowledge about Mycobacterium africanum and report the incidence and characteristics of tuberculosis (TB) due to their lineages in Aragon, Spain, over the period 2003–2019
27 patients were born in West African countries (87.09%), three were Spaniards (9.67%), and one patient was born in Bulgaria
We studied the location of IS6110 in three L6 strains using ligation-mediated PCR (LM-PCR) within a study of Mycobacterium tuberculosis complex (MTBC) strains with a low copy number of this insertion sequence (IS)
Summary
The purpose of this study was to increase our knowledge about Mycobacterium africanum and report the incidence and characteristics of tuberculosis (TB) due to their lineages in Aragon, Spain, over the period 2003–2019. The isolates’ characterisation identified a copy of IS6110 within the moaX gene, which turned out to be specific for L6 It will allow the differentiation of this lineage from the rest of MTBC with a simple PCR reaction. There are three hypotheses being considered of why M. africanum is almost restricted to West Africa: it is not able to compete with modern M. tuberculosis lineages[6]; it is adapted to the African population[7,8]; and there could be an animal reservoir, being a zoonotic d isease[5,9,10,11,12] Regarding phylogeny, both M. africanum L5 and L6 have a common ancestor with the region of difference (RD) 9 deleted[13,14]. To our knowledge, the location of IS6110 in the genome of M. africanum strains has not been studied until now
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