Abstract
BackgroundMexico is one of the most important contributors of drug and multidrug-resistant tuberculosis in Latin America; however, knowledge of the genetic diversity of drug-resistant tuberculosis isolates is limited.MethodsIn this study, the genetic structure of 112 Mycobacterium tuberculosis strains from the southeastern Mexico was determined by spoligotyping and 24-loci MIRU-VNTRs.FindingsThe results show eight major lineages, the most of which was T1 (24%), followed by LAM (16%) and H (15%). A total of 29 (25%) isolates were identified as orphan. The most abundant SITs were SIT53/T1 and SIT42/LAM9 with 10 isolates each and SIT50/H3 with eight isolates. Fifty-two spoligotype patterns, twenty-seven clusters and ten clonal complexes were observed, demonstrating an important genetic diversity of drug and multidrug-resistant tuberculosis isolates in circulation and transmission level of these aggravated forms of tuberculosis. Being defined as orphan or as part of an orphan cluster, was a risk factor for multidrug resistant-tuberculosis (OR 2.5, IC 1.05–5.86 and OR 3.3, IC 1–11.03, respectively). Multiple correspondence analyses showed association of some clusters and SITs with specific geographical locations.ConclusionsOur study provides one of the most detailed description of the genetic structure of drug and multidrug-resistant tuberculosis strains in southeast Mexico, establishing for the first time a baseline of the genotypes observed in resistant isolates circulating, however further studies are required to better elucidate the genetic structure of tuberculosis in region and the factors that could be participating in their dispersion.
Highlights
Over recent decades, the worldwide resurgence of tuberculosis (TB) has been a challenge for health institutions
Our study provides one of the most detailed description of the genetic structure of drug and multidrug-resistant tuberculosis strains in southeast Mexico, establishing for the first time a baseline of the genotypes observed in resistant isolates circulating, further studies are required to better elucidate the genetic structure of tuberculosis in region and the factors that could be participating in their dispersion
According to the global TB report of the World Health Organization, in 2015, TB was responsible for the deaths of 1.5 million people and generated 10.4 million cases, of which 100,000 were drug resistant tuberculosis (DR-TB) with specific resistance against rifampicin-resistant (RR-TB), 480,000 presenting combined resistance to rifampin and isoniazid and considered as multidrug resistant (MDR-TB), and 7579 showed extreme drug resistance (XDR-TB) [1]
Summary
The worldwide resurgence of tuberculosis (TB) has been a challenge for health institutions. The use of tools that allow characterization and genotypic analysis of TB, such as 24-locus mycobacterial interspersed repetitive unit-variable-number tandem-repeat (MIRU-VNTR) and spacer oligonucleotide typing (spoligotyping), allow an understanding of the dynamics and complexity of the population structure of Mycobacterium tuberculosis within a population [3,4] These procedures allow identification of the different lineages in circulation within specific regions and their relationship with potential pathogenicity and virulence [5,6] several reports from different geographic regions have described the levels of association with demographic, epidemiological and drug resistance characteristics [7,8,9,10,11,12]. Mexico is one of the most important contributors of drug and multidrug-resistant tuberculosis in Latin America; knowledge of the genetic diversity of drug-resistant tuberculosis isolates is limited
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