The Impact of the Mycobacterium tuberculosis RDRio Subfamily on Multidrug-Resistant Tuberculosis in Latin America: A Comprehensive Review.

Abstract

Latin American region is a high-burden setting for tuberculosis where multidrug-resistant tuberculosis (MDR-TB) is among the main challenge to move forward the End TB Strategy goals. It has been shown that MDR-TB is associated to certain Mycobacterium tuberculosis (MTB) lineages like L2-Beijing sublineage or L4-LAM. Although L2-Beijing is present in South America, the L4 lineage is the most prevalent with values ranging from 75% to 99% depending on the country. Within L4, Latin American-Mediterranean (LAM) family is the most prevalent. Moreover, within LAM, RDRio subfamily is present in high prevalence in several countries in South America like Venezuela or Brazil. RDRio has been associated to MDR-TB in several studies in Brazil but more epidemiological information is needed for South America. Here we discuss the problem of MDR-TB in Latin America and the potential threat that RDRio could represent. At this time, more molecular epidemiology studies are necessary to improve TB surveillance programs in Latin America by tracking MTB strains potentially responsible for MDR-TB spread.