Abstract
This study was performed to investigate the role of dysglycemia on the genetic diversity of Mycobacterium tuberculosis (MTB) among pulmonary tuberculosis (TB) patients to build scientific evidence about the possible mechanisms of TB transmission. MTB isolates obtained of patients affected by pulmonary tuberculosis from health care facilities of North Lima—Peru, were analyzed using whole genome sequencing and 24-locus mycobacterial interspersed repetitive-unit -variable-number tandem repeats (MIRU-VNTR). Subsequently, clinical and epidemiological characteristics were associated with clustering, lineages and comorbid conditions. The analysis carried out 112 pulmonary TB patients from various health centers in North Lima, 17 (15%) had diabetes mellitus (DM) and 33 (29%) had pre-diabetes (PDM). Latin American-Mediterranean, Haarlem and Beijing were the most frequent MTB lineages found in those patients. Previous TB (adjusted odds ratio [aOR] = 3.65; 95%CI: 1.32–17.81), age (aOR = 1.12; 95%CI: 1.03–1.45) and Beijing lineage (aOR = 3.53; 95%CI: 1.08–13.2) were associated with TB-DM comorbidity. Alcoholism (aOR = 2.92; 95%CI: 1.10–8.28), age (aOR = 1.05; 95%CI: 1.03–1.12) and Haarlem lineage (aOR = 2.54; 95%CI: 1.04–6.51) were associated with TB-PDM comorbidity. Beijing and Haarlem lineages were independently associated with TB-DM and TB-PDM comorbidities, respectively. Although these findings may be surprising, we must be cautious to suggest that dysglycemia could be associated with a highly clustering and predisposition of MTB lineages related to a serious impact on the severity of TB disease, which requires further research.
Highlights
Since recent years, dysglycemic conditions; known as diabetes mellitus (DM) and pre-diabetes (PDM), have been frequently reported in countries where tuberculosis (TB) is highly endemic [1,2,3,4]
There was no significant difference in TB symptoms such as fever>15 days, cough>15 days, blood in sputum and night sweats between patients with only TB and TB patients with dysglycemia (Table 1)
Our findings give us an insight of Mycobacterium tuberculosis (MTB) lineages distribution among TB patients affected by DM or PDM from some health care facilities of North Lima
Summary
Dysglycemic conditions; known as diabetes mellitus (DM) and pre-diabetes (PDM), have been frequently reported in countries where tuberculosis (TB) is highly endemic [1,2,3,4]. Prediabetes (PDM) which is a status of progression to diabetes risk has been associated with the development of TB disease [7]. The comorbidity was not an important public health issue in low- and middle-income countries but the relevance of this situation has progressively changed due to urbanization and lifestyles changes [8]. The data in this regard is still very limited in Peru, which is why we are joining through different efforts to learn more about comorbidity [9] to try know if this could impact in the risk of TB transmission and simultaneously explain the clinical burden of tuberculosis in the country
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