Abstract
BackgroundForeign-born patients with tuberculosis (TB) may introduce globally disseminated isolates of Mycobacterium tuberculosis into large cities in Japan. The risk of dissemination of these isolates into local regions, however, has not been determined. This study analyzed the molecular epidemiology of M. tuberculosis isolates obtained from TB patients living in a local region of Japan.MethodsWhole genome sequences of 169 M. tuberculosis isolates, obtained from 148 Japanese-born and 21 foreign-born patients living in Tochigi, Japan, were analyzed using the Comprehensive analysis server for the Mycobacteriumtuberculosis complex (CASTB).ResultsThe 169 isolates were clustered into four clades; Lineage 2 (111 isolates 65.7%), Lineage 4 (43 isolates, 25.4%), Lineage 1 (13 isolates, 7.7%), and Lineage 3 (2 isolates, 1.2%). Of the 111 isolates belonging to Lineage 2, 79 (71.2%) were of the atypical Beijing sub-genotype. Of the 13 Lineage 1 isolates, nine (69.2%) were from foreign-born patients. The isolates belonging to Lineage 4 were further clustered into three clades, two containing isolates shared by both Japanese- and foreign-born patients. The two isolates belonging to Lineage 3 were obtained from foreign-born patients.ConclusionsThe genotypic diversity of M. tuberculosis in a local region of Japan is increased primarily by the presence of isolates obtained from foreign-born patients.
Highlights
Foreign-born patients with tuberculosis (TB) may introduce globally disseminated isolates of Mycobacterium tuberculosis into large cities in Japan
Phylogenetic and lineage analyses maximum likelihood (ML) trees were constructed from the 169 M. tuberculosis isolates obtained from patients registered in the National Epidemiological Surveillance of Infectious Diseases (NESID) in 2007 and 2013 (Fig. 1a and b)
Of the 111 isolates belonging to Lineage 2, 107 (96.4%) were from Japan-born patients and only four (3.6%) from foreign-born patients (Table 1), with one each of the latter belonging to each of the four sub-clades of Lineage 2 (Fig. 3b)
Summary
Foreign-born patients with tuberculosis (TB) may introduce globally disseminated isolates of Mycobacterium tuberculosis into large cities in Japan. The risk of dissemination of these isolates into local regions, has not been determined. This study analyzed the molecular epidemiology of M. tuberculosis isolates obtained from TB patients living in a local region of Japan. Recent molecular epidemiologic studies of M. tuberculosis have provided important information on epidemic and drug-resistant strains and on their relationships [4, 5]. Mizukoshi et al BMC Infectious Diseases (2017) 17:365 methods used to assess TB strains have included determination of variable numbers of tandem repeats, spoligotyping, IS6110-based restriction fragment length polymorphism (RFLP) typing, lineage analysis based on long sequence polymorphisms (LSP), and Beijing typing [6,7,8,9,10]. Detection of mutations associated with drug resistance is important due to the increasing number of patients with drug-resistant TB [14]
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