Abstract
We present the first comprehensive analysis of Mycobacterium tuberculosis isolates circulating in the Kaohsiung region of southern Taiwan. The major spoligotypes found in the 224 isolates studied were Beijing lineages (n = 97; 43.3%), EAI lineages (n = 72; 32.1%) and Haarlem lineages (n = 18; 8.0%). By 24 MIRU-VNTR typing, 174 patterns were identified, including 24 clusters of 74 isolates and 150 unique patterns. The combination of spoligotyping and 12-MIRU-VNTR revealed that 129 (57.6%) of the 224 isolates were clustered in 18 genotypes. Moreover, 63.6% (7/11) of infected persons younger than 30 years had a Beijing strain, which could suggest recent spread among younger persons by this family of TB strains in Kaohsiung. Among the 94 Beijing family (SIT1, SIT250 and SIT1674) isolates further analyzed for SNPs by mass spectrometry, the most frequent strain found was ST10 (n = 49; 52%), followed by ST22 (n = 17; 18%) and ST19 (n = 11; 12%). Among the EAI-Manila family isolates analyzed by region deletion-based subtyping, the most frequent strain found was RD type 1 (n = 63; 87.5%), followed by RD type 2 (n = 9; 12.5%). In our previous study, the proportion of modern Beijing strains (52.5%) in northern Taiwan was significantly higher than the proportion of EAI strains (11%). In contrast, in the present study, EAI strains comprised up to 32% of Beijing strains in southern Taiwan. In conclusion, both ‘modern’ (Beijing) and ‘ancient’ (EAI) M. tuberculosis strains are prevalent in the Kaohsiung region, perhaps suggesting that both strains are somehow more adapted to southern Taiwan. It will be interesting to investigate the dynamics of the lineage composition by different selection pressures.
Highlights
Tuberculosis (TB) remains a worldwide healthcare concern and is characterized by the World Health Organization (WHO) as an epidemic
A total of 224 isolates from 224 patients who were diagnosed with cultureconfirmed TB were subjected to spoligotyping and MIRU-VNTR
Of the remaining 15 isolates that were not represented in SITVITWEB, 2 were East African-India (EAI), 5 were Family-33, 4 were Haarlem, was T, 1 was LAM, 1 was Family-36, and 1 was Beijing, based on Spotclust (Table 2)
Summary
Tuberculosis (TB) remains a worldwide healthcare concern and is characterized by the World Health Organization (WHO) as an epidemic. TB is a leading notifiable communicable disease on the island of Taiwan. In 2008, 14,265 cases (62.0/100,000) were reported, with the highest numbers of new TB patients occurring in Taipei County (2,147 cases; 15.05%) and Taipei City (1,178; 8.25%) in the north and in Kaohsiung County (1,061; 7.43%) and Kaohsiung City (1,009; 7.07%) in the south. Kaohsiung is the second largest city of Taiwan, with a population of around 2.9 million. While the levels of TB infection and mortality are high in southern Taiwan, there are fewer documented genotyping studies of pulmonary Mycobacterium tuberculosis (MTB). Isolates in southern Taiwan than in northern Taiwan [1]. It is of interest to understand genotypic patterns of pulmonary MTB isolates in southern Taiwan and how they
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