Abstract

BackgroundAt present, there are few studies on polymorphism of Mycobacterium tuberculosis (Mtb) gene and how it affects the TB epidemic. This study aimed to document the differences of polymorphisms between tuberculosis hot and cold spot areas of Guangxi Zhuang Autonomous Region, China.MethodsThe cold and hot spot areas, each with 3 counties, had been pre-identified by TB incidence for 5 years from the surveillance database. Whole genome sequencing analysis was performed on all sputum Mtb isolates from the detected cases during January and June 2018. Single nucleotide polymorphism (SNP) of each isolate compared to the H37Rv strain were called and used for lineage and sub-lineage identification. Pairwise SNP differences between every pair of isolates were computed. Analyses of Molecular Variance (AMOVA) across counties of the same hot or cold spot area and between the two areas were performed.ResultsAs a whole, 59.8% (57.7% sub-lineage 2.2 and 2.1% sub-lineage 2.1) and 39.8% (17.8% sub-lineage 4.4, 6.5% sub-lineage 4.2 and 15.5% sub-lineage 4.5) of the Mtb strains were Lineage 2 and Lineage 4 respectively. The percentages of sub-lineage 2.2 (Beijing family strains) are significantly higher in hot spots. Through the MDS dimension reduction, the genomic population structure in the three hot spot counties is significantly different from those three cold spot counties (T-test p = 0.05). The median of SNPs distances among Mtb isolates in cold spots was greater than that in hot spots (897 vs 746, Rank-sum test p < 0.001). Three genomic clusters, each with genomic distance ≤12 SNPs, were identified with 2, 3 and 4 consanguineous strains. Two clusters were from hot spots and one was from cold spots.ConclusionNarrower genotype diversity in the hot area may indicate higher transmissibility of the Mtb strains in the area compared to those in the cold spot area.

Highlights

  • At present, there are few studies on polymorphism of Mycobacterium tuberculosis (Mtb) gene and how it affects the TB epidemic

  • All Mtb isolates from the culture were shipped to the Guangxi center for disease prevention and control (GXCDC) where Mtb deoxyribonucleic acid (DNA) extraction was performed before transporting the DNA to Zeta Biosciences company (Shanghai) for Whole genome sequencing (WGS) and upstream data analysis

  • After excluding 13 participants (8 patients with nontuberculosis mycobacteria infection and 5 patients with low quality of Mtb DNA), a total of 147 isolates from hot spots and 144 from cold spots were included for further analysis

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Summary

Introduction

There are few studies on polymorphism of Mycobacterium tuberculosis (Mtb) gene and how it affects the TB epidemic. This study aimed to document the differences of polymorphisms between tuberculosis hot and cold spot areas of Guangxi Zhuang Autonomous Region, China. It is widely recognized that Mycobacterium tuberculosis (Mtb) of different molecular types have different transmission capacities, pathogenicity and drug resistance rates [1, 2]. Guangxi Zhuang Autonomous Region is a southern region of China with a seriously high TB prevalence [5]. The internal TB situation in Guangxi varies greatly. Previous spatiotemporal studies found a significantly high notification spatial cluster (hot spots) and a significantly low notification spatial cluster (cold spots) through spatiotemporal scanning technology [6]. The molecular biological explanations for this situation are still lacking

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