Abstract
BackgroundThe aim of the current study was to improve our understanding of the origins and transmission of Mycobacterium africanum (MAF) in Norway.MethodsWhole-genome sequences (WGS) were generated for all (n = 29) available clinical isolates received at the Norwegian National Reference Laboratory for Mycobacteria (NRL) and identified as MAF in Norway, in the period 2010–2020. Phylogenetic analyses were performed.ResultsThe analyses indicated several imports of MAF lineage 6 from both East and West African countries, whereas MAF lineage 5 was restricted to patients with West African connections. We also find evidence for transmission of MAF in Norway. Finally, our analyses revealed that a group of isolates from patients originating in South Asia, identified as MAF by means of a commercial line-probe assay, in fact belonged to Mycobacterium orygis.ConclusionsMost MAF cases in Norway are the result of import, but transmission is occurring within Norway.
Highlights
The aim of the current study was to improve our understanding of the origins and transmission of Mycobacterium africanum (MAF) in Norway
Infections caused by members of the Mycobacterium tuberculosis complex (MTBC) other than M. tuberculosis make up a significant proportion of tuberculosis cases in West African countries [21]
The identification by Whole-genome sequences (WGS) of surprisingly closely related MAF cases, including patients born in countries where MAF is not known to be endemic, prompted us to re-culture, sequence and characterize all MAF isolates received at the National Reference Laboratory for Mycobacteria (NRL) from the period 2010–2020
Summary
The aim of the current study was to improve our understanding of the origins and transmission of Mycobacterium africanum (MAF) in Norway. Methods: Whole-genome sequences (WGS) were generated for all (n = 29) available clinical isolates received at the Norwegian National Reference Laboratory for Mycobacteria (NRL) and identified as MAF in Norway, in the period 2010–2020. From 2016, the Norwegian National Reference Laboratory for Mycobacteria (NRL) has characterized all MTBC isolates from notified culture positive tuberculosis (TB) cases in Norway, by means of whole-genome sequencing (WGS), significantly improving our ability to both accurately identify species and detect recent transmission. The majority of TB cases in Norway are the result of imported disease rather than transmission in the country [7] Compared to M. tuberculosis, Mycobacterium africanum (MAF) infections have been suggested to possess reduced capacity for generating active disease and to be less transmissible, but the latter finding is actively debated [1, 11, 13, 17]. The identification by WGS of surprisingly closely related MAF cases, including patients born in countries where MAF is not known to be endemic, prompted us to re-culture, sequence and characterize all MAF isolates received at the NRL from the period 2010–2020
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