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Rasigade JP, Barbier M, Dumitrescu O, Pichat C, Carret G, Ronnaux-Baron AS, Blasquez G, Godin-Benhaim C, Boisset S, Carricajo A, Jacomo V, Fredenucci I, Pérouse de Montclos M, Flandrois JP, Ader F, Supply P, Lina G, Wirth T. Strain-specific estimation of epidemic success provides insights into the transmission dynamics of tuberculosis. Sci Rep 2017; 7:45326. [PMID: 28349973 PMCID: PMC5368603 DOI: 10.1038/srep45326] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 02/21/2017] [Indexed: 12/03/2022] Open
Abstract
The transmission dynamics of tuberculosis involves complex interactions of socio-economic and, possibly, microbiological factors. We describe an analytical framework to infer factors of epidemic success based on the joint analysis of epidemiological, clinical and pathogen genetic data. We derive isolate-specific, genetic distance-based estimates of epidemic success, and we represent success-related time-dependent concepts, namely epidemicity and endemicity, by restricting analysis to specific time scales. The method is applied to analyze a surveillance-based cohort of 1,641 tuberculosis patients with minisatellite-based isolate genotypes. Known predictors of isolate endemicity (older age, native status) and epidemicity (younger age, sputum smear positivity) were identified with high confidence (P < 0.001). Long-term epidemic success also correlated with the ability of Euro-American and Beijing MTBC lineages to cause active pulmonary infection, independent of patient age and country of origin. Our results demonstrate how important insights into the transmission dynamics of tuberculosis can be gained from active surveillance data.
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Affiliation(s)
- Jean-Philippe Rasigade
- Institut de Systématique, Evolution, Biodiversité, UMR-CNRS 7205, Muséum National d'Histoire Naturelle, Université Pierre et Marie Curie, Ecole Pratique des Hautes Etudes, Sorbonne Universités, Paris, France.,Laboratoire Biologie Intégrative des Populations, Ecole Pratique des Hautes Etudes, PSL Research University, Paris, France.,Centre International de Recherche en Infectiologie, CIRI, University of Lyon, France.,Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Maxime Barbier
- Institut de Systématique, Evolution, Biodiversité, UMR-CNRS 7205, Muséum National d'Histoire Naturelle, Université Pierre et Marie Curie, Ecole Pratique des Hautes Etudes, Sorbonne Universités, Paris, France.,Laboratoire Biologie Intégrative des Populations, Ecole Pratique des Hautes Etudes, PSL Research University, Paris, France
| | - Oana Dumitrescu
- Centre International de Recherche en Infectiologie, CIRI, University of Lyon, France.,Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Catherine Pichat
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Gérard Carret
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | | | | | | | - Sandrine Boisset
- Laboratoire de Bactériologie, Institut de Biologie et de Pathologie, CHU de Grenoble, Grenoble, France.,Laboratoire TIMC-IMAG, UMR 5525 CNRS-UJF, UFR de Médecine, Université Grenoble Alpes, Grenoble, France
| | - Anne Carricajo
- Laboratoire des Agents Infectieux et d'Hygiène, CHU de Saint-Etienne, Saint-Etienne, France
| | | | | | | | - Jean-Pierre Flandrois
- Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France.,Laboratoire de Biométrie et Biologie Evolutive, UMR CNRS 5558, University of Lyon, France
| | - Florence Ader
- Centre International de Recherche en Infectiologie, CIRI, University of Lyon, France.,Service des Maladies Infectieuses et Tropicales, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France
| | - Philip Supply
- INSERM U1019, CNRS-UMR 8204, Center for Infection and Immunity of Lille, Institut Pasteur de Lille, Université de Lille, Lille, France
| | - Gérard Lina
- Centre International de Recherche en Infectiologie, CIRI, University of Lyon, France.,Institut des Agents Infectieux, Hospices Civils de Lyon, Lyon, France
| | - Thierry Wirth
- Institut de Systématique, Evolution, Biodiversité, UMR-CNRS 7205, Muséum National d'Histoire Naturelle, Université Pierre et Marie Curie, Ecole Pratique des Hautes Etudes, Sorbonne Universités, Paris, France.,Laboratoire Biologie Intégrative des Populations, Ecole Pratique des Hautes Etudes, PSL Research University, Paris, France
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Abstract
ABSTRACT
With the advent of next-generation sequencing technology, the genotyping of clinical
Mycobacterium tuberculosis
strains went through a major breakup that dramatically improved the field of molecular epidemiology but also revolutionized our deep understanding of the
M. tuberculosis
complex evolutionary history. The intricate paths of the pathogen and its human host are reflected by a common geographical origin in Africa and strong biogeographical associations that largely reflect the past migration waves out of Africa. This long coevolutionary history is cardinal for our understanding of the host-pathogen dynamic, including past and ongoing demographic components, strains’ genetic background, as well as the immune system genetic architecture of the host. Coalescent- and Bayesian-based analyses allowed us to reconstruct population size changes of
M. tuberculosis
through time, to date the most recent common ancestor and the several phylogenetic lineages. This information will ultimately help us to understand the spread of the Beijing lineage, the rise of multidrug-resistant sublineages, or the fall of others in the light of socioeconomic events, antibiotic programs, or host population densities. If we leave the present and go through the looking glass, thanks to our ability to handle small degraded molecules combined with targeted capture, paleomicrobiology covering the Pleistocene era will possibly unravel lineage replacements, dig out extinct ones, and eventually ask for major revisions of the current model.
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