Abstract
BackgroundTuberculosis (TB) control strategies are focused mainly on prevention, early diagnosis, compliance to treatment and contact tracing. The objectives of this study were to explore the frequency and risk factors of recent transmission of clinical isolates of Mycobacterium tuberculosis complex (MTBC) in Cantabria in Northern Spain from 2012 through 2013 and to analyze their clonal complexity for better understanding of the transmission dynamics in a moderate TB incidence setting.MethodsDNA from 85 out of 87 isolates from bacteriologically confirmed cases of MTBC infection were extracted directly from frozen stocks and genotyped using the mycobacterial interspersed repetitive units-variable number tandem repeat (MIRU-VNTR) method. The MIRU-VNTRplus database tool was used to identify clusters and lineages and to build a neighbor joining (NJ) phylogenetic tree. In addition, data were compared to the SITVIT2 database at the Pasteur Institute of Guadeloupe.ResultsThe rate of recent transmission was calculated to 24%. Clustering was associated with being Spanish-born. A high prevalence of isolates of the Euro-American lineage was found. In addition, MIRU-VNTR profiles of the studied isolates corresponded to previously found MIRU-VNTR types in other countries, including Spain, Belgium, Great Britain, USA, Croatia, South Africa and The Netherlands. Six of the strains analyzed represented clonal variants.ConclusionTransmission of MTBC is well controlled in Cantabria. The majority of TB patients were born in Spain. The population structure of MTBC in Cantabria has a low diversity of major clonal lineages with the Euro-American lineage predominating.
Highlights
The incidence of TB has gradually decreased worldwide, but remains a major global health problem with 1.5 million deaths in 2013 [1]
Transmission of Mycobacterium tuberculosis complex (MTBC) is well controlled in Cantabria
The population structure of MTBC in Cantabria has a low diversity of major clonal lineages with the Euro-American lineage predominating
Summary
The incidence of TB has gradually decreased worldwide, but remains a major global health problem with 1.5 million deaths in 2013 [1]. In Cantabria, a coastal region located in the North of Spain, a similar incidence of 12.4 TB cases per 100,000 inhabitants was observed [2]. This is far from the eradication target stated by WHO for 2050 defined as less than one case per million inhabitants per year in developed countries [1]. During the last two decades, DNA genotyping techniques have been used to study MTBC strains, in particular issues related to recent transmission of the bacteria [3,4,5,6,7,8,9,10,11,12,13]. The objectives of this study were to explore the frequency and risk factors of recent transmission of clinical isolates of Mycobacterium tuberculosis complex (MTBC) in Cantabria in Northern Spain from 2012 through 2013 and to analyze their clonal complexity for better understanding of the transmission dynamics in a moderate TB incidence setting
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