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Bouziane F, Allem R, Sebaihia M, Kumanski S, Mougari F, Sougakoff W, Raskine L, Yala D, Cambau E. First genetic characterisation of multidrug-resistant Mycobacterium tuberculosis isolates from Algeria. J Glob Antimicrob Resist 2019; 19:301-307. [PMID: 31100498 DOI: 10.1016/j.jgar.2019.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 04/30/2019] [Accepted: 05/04/2019] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES To characterise the genotypes of multidrug-resistant (MDR) Mycobacterium tuberculosis (MTB) isolated in Algeria, where there is a low MDR-MTB incidence rate. METHODS Ten MDR isolates and one resistant to isoniazid were investigated by PCR-Sanger sequencing for 10 loci involved in resistance. Amplicon-based next generation sequencing (NGS) of 15 loci was additionally performed on isolates harbouring novel mutations. RESULTS Sanger and amplicon-NGS provided the same results as with GenoType kits. Mutations known to be associated with resistance were described for most isolates: rpoB S531L in seven of 10 rifampicin-R MTB isolates, katG S315T in nine of 11 isoniazid-R, and promoter inhA c-15t in three of 11, embB M306V or M306I in two of two ethambutol-R, rpsL K43R in four of eight or rrs a514c associated with gidB L16R in streptomycin-R, gyrA A90V in the ofloxacin-R pre-XDR isolate. New and rare mutations were also described in rpoB (deletion 512-513-514), katG (S315R, M126I/ R496L), gidB (V124G, E92A, V139A, G37V), and gyrA (P8A). Mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) profiles were similar for three isolates (lineage Cameroon), indicating a possible clonal diffusion in epidemiologically unrelated patients. CONCLUSIONS Resistant MTB isolates in Algeria harbour resistance genotypes similar to other countries, but some rare patterns may result from selection and transmission processes inherent to the country.
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Affiliation(s)
- Feriel Bouziane
- Laboratoire de Biologie Moléculaire, Génomique et Bio-Informatique-Département de Biologie, Faculté des Sciences, Université Hassiba Ben Bouali, Chlef, Algeria
| | - Rachida Allem
- Laboratoire de Bio Ressources Naturelles, Département de Biologie, Faculté des Sciences, Université Hassiba Ben Bouali, Chlef, Algeria
| | - Mohammed Sebaihia
- Laboratoire de Biologie Moléculaire, Génomique et Bio-Informatique-Département de Biologie, Faculté des Sciences, Université Hassiba Ben Bouali, Chlef, Algeria
| | - Sylvain Kumanski
- AP-HP, Laboratoire de Bactériologie, Centre National de Référence Des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, GH Lariboisière-Fernand Widal, Paris, France
| | - Faiza Mougari
- AP-HP, Laboratoire de Bactériologie, Centre National de Référence Des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, GH Lariboisière-Fernand Widal, Paris, France; Iame, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Wladimir Sougakoff
- AP-HP, Laboratoire de Bactériologie-Hygiène, Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, GH Pitié-Salpêtrière, Paris, France
| | - Laurent Raskine
- AP-HP, Laboratoire de Bactériologie, Centre National de Référence Des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, GH Lariboisière-Fernand Widal, Paris, France
| | - Djamel Yala
- Laboratoire National de Référence pour la Tuberculose et Mycobactéries, Institut Pasteur, Alger, Algeria
| | - Emmanuelle Cambau
- AP-HP, Laboratoire de Bactériologie, Centre National de Référence Des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, GH Lariboisière-Fernand Widal, Paris, France; Iame, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
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Armas F, Camperio C, Coltella L, Selvaggini S, Boniotti MB, Pacciarini ML, Di Marco Lo Presti V, Marianelli C. Comparison of semi-automated commercial rep-PCR fingerprinting, spoligotyping, 12-locus MIRU-VNTR typing and single nucleotide polymorphism analysis of the embB gene as molecular typing tools for Mycobacterium bovis. J Med Microbiol 2017; 66:1151-1157. [DOI: 10.1099/jmm.0.000536] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Federica Armas
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Cristina Camperio
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
| | - Luana Coltella
- Microbiology Laboratory, Bambino Gesù Paediatric Hospital, Rome, Italy
| | | | - Maria Beatrice Boniotti
- National Reference Centre for Mycobacterium Bovis Tuberculosis, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna, Brescia, Italy
| | - Maria Lodovica Pacciarini
- National Reference Centre for Mycobacterium Bovis Tuberculosis, Istituto Zooprofilattico Sperimentale della Lombardia e dell’Emilia Romagna, Brescia, Italy
| | | | - Cinzia Marianelli
- Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità, Rome, Italy
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Use of whole-genome sequencing to distinguish relapse from reinfection in a completed tuberculosis clinical trial. BMC Med 2017; 15:71. [PMID: 28351427 PMCID: PMC5371199 DOI: 10.1186/s12916-017-0834-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/09/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND RIFAQUIN was a tuberculosis chemotherapy trial in southern Africa including regimens with high-dose rifapentine with moxifloxacin. Here, the application of whole-genome sequencing (WGS) is evaluated within RIFAQUIN for identifying new infections in treated patients as either relapses or reinfections. WGS is further compared with mycobacterial interspersed repetitive units-variable number tandem repeats (MIRU-VNTR) typing. This is the first report of WGS being used to evaluate new infections in a completed clinical trial for which all treatment and epidemiological data are available for analysis. METHODS DNA from 36 paired samples of Mycobacterium tuberculosis cultured from patients before and after treatment was typed using 24-loci MIRU-VNTR, in silico spoligotyping and WGS. Following WGS, the sequences were mapped against the reference strain H37Rv, the single-nucleotide polymorphism (SNP) differences between pairs were identified, and a phylogenetic reconstruction was performed. RESULTS WGS indicated that 32 of the paired samples had a very low number of SNP differences (0-5; likely relapses). One pair had an intermediate number of SNP differences, and was likely the result of a mixed infection with a pre-treatment minor genotype that was highly related to the post-treatment genotype; this was reclassified as a relapse, in contrast to the MIRU-VNTR result. The remaining three pairs had very high SNP differences (>750; likely reinfections). CONCLUSIONS WGS and MIRU-VNTR both similarly differentiated relapses and reinfections, but WGS provided significant extra information. The low proportion of reinfections seen suggests that in standard chemotherapy trials with up to 24 months of follow-up, typing the strains brings little benefit to an analysis of the trial outcome in terms of differentiating relapse and reinfection. However, there is a benefit to using WGS as compared to MIRU-VNTR in terms of the additional genotype information obtained, in particular for defining the presence of mixed infections and the potential to identify known and novel drug-resistance markers.
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Methodological and Clinical Aspects of the Molecular Epidemiology of Mycobacterium tuberculosis and Other Mycobacteria. Clin Microbiol Rev 2016; 29:239-90. [PMID: 26912567 DOI: 10.1128/cmr.00055-15] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Molecular typing has revolutionized epidemiological studies of infectious diseases, including those of a mycobacterial etiology. With the advent of fingerprinting techniques, many traditional concepts regarding transmission, infectivity, or pathogenicity of mycobacterial bacilli have been revisited, and their conventional interpretations have been challenged. Since the mid-1990s, when the first typing methods were introduced, a plethora of other modalities have been proposed. So-called molecular epidemiology has become an essential subdiscipline of modern mycobacteriology. It serves as a resource for understanding the key issues in the epidemiology of tuberculosis and other mycobacterial diseases. Among these issues are disclosing sources of infection, quantifying recent transmission, identifying transmission links, discerning reinfection from relapse, tracking the geographic distribution and clonal expansion of specific strains, and exploring the genetic mechanisms underlying specific phenotypic traits, including virulence, organ tropism, transmissibility, or drug resistance. Since genotyping continues to unravel the biology of mycobacteria, it offers enormous promise in the fight against and prevention of the diseases caused by these pathogens. In this review, molecular typing methods for Mycobacterium tuberculosis and nontuberculous mycobacteria elaborated over the last 2 decades are summarized. The relevance of these methods to the epidemiological investigation, diagnosis, evolution, and control of mycobacterial diseases is discussed.
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Description of compensatorygyrAmutations restoring fluoroquinolone susceptibility inMycobacterium tuberculosis. J Antimicrob Chemother 2016; 71:2428-31. [DOI: 10.1093/jac/dkw169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 04/11/2016] [Indexed: 11/14/2022] Open
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Implementation of a Consensus Set of Hypervariable Mycobacterial Interspersed Repetitive-Unit-Variable-Number Tandem-Repeat Loci in Mycobacterium tuberculosis Molecular Epidemiology. J Clin Microbiol 2015; 54:478-82. [PMID: 26659207 DOI: 10.1128/jcm.02945-15] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 11/21/2015] [Indexed: 11/20/2022] Open
Abstract
This study shows that the addition of a consensus 4-locus set of hypervariable mycobacterial interspersed repetitive-unit-variable-number tandem repeat (MIRU-VNTR) loci to the spoligotyping-24-locus MIRU-VNTR typing strategy is a well-standardized approach that can contribute to an improvement of the true cluster definition while retaining high typeability in non-Beijing strains.
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Dantas NGT, Suffys PN, Carvalho WDS, Gomes HM, de Almeida IN, de Assis LJ, Augusto CJ, Gomgnimbou MK, Refregier G, Sola C, de Miranda SS. Genetic diversity and molecular epidemiology of multidrug-resistant Mycobacterium tuberculosis in Minas Gerais State, Brazil. BMC Infect Dis 2015; 15:306. [PMID: 26231661 PMCID: PMC4521345 DOI: 10.1186/s12879-015-1057-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/23/2015] [Indexed: 11/22/2022] Open
Abstract
Background We aimed to characterize the genetic diversity of drug-resistant Mycobacterium tuberculosis (MTb) clinical isolates and investigate the molecular epidemiology of multidrug-resistant (MDR) tuberculosis from Minas Gerais State, Brazil. Methods One hundred and four MTb clinical isolates were assessed by IS6110-RFLP, 24-locus mycobacterial interspersed repetitive units variable-number tandem repeats (MIRU-VNTR), TB-SPRINT (simultaneous spoligotyping and rifampicin-isoniazid drug-resistance mutation analysis) and 3R-SNP-typing (analysis of single-nucleotide polymorphisms in the genes involved in replication, recombination and repair functions). Results Fifty-seven different IS6110-RFLP patterns were found, among which 50 had unique patterns and 17 were grouped into seven clusters. The discriminatory index (Hunter and Gaston, HGDI) for RFLP was 0.9937. Ninety-nine different MIRU-VNTR patterns were found, 95 of which had unique patterns and nine isolates were grouped into four clusters. The major allelic diversity index in the MIRU-VNTR loci ranged from 0.6568 to 0.7789. The global HGDI for MIRU-VNTR was 0.9991. Thirty-two different spoligotyping profiles were found: 16 unique patterns (n = 16) and 16 clustered profiles (n = 88). The HGDI for spoligotyping was 0.9009. The spoligotyped clinical isolates were phylogenetically classified into Latin-American Mediterranean (66.34 %), T (14.42 %), Haarlem (5.76 %), X (1.92 %), S (1.92 %) and U (unknown profile; 8.65 %). Among the U isolates, 77.8 % were classified further by 3R-SNP-typing as 44.5 % Haarlem and 33.3 % LAM, while the 22.2 % remaining were not classified. Among the 104 clinical isolates, 86 were identified by TB-SPRINT as MDR, 12 were resistant to rifampicin only, one was resistant to isoniazid only, three were susceptible to both drugs, and two were not successfully amplified by PCR. A total of 42, 28 and eight isolates had mutations in rpoB positions 531, 526 and 516, respectively. Correlating the cluster analysis with the patient data did not suggest recent transmission of MDR-TB. Conclusions Although our results do not suggest strong transmission of MDR-TB in Minas Gerais (using a classical 100 % MDR-TB identical isolates cluster definition), use of a smoother cluster definition (>85 % similarity) does not allow us to fully eliminate this possibility; hence, around 20–30 % of the isolates we analyzed might be MDR-TB transmission cases.
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Affiliation(s)
- Nayanne Gama Teixeira Dantas
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, Department of Internal medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Phillip Noel Suffys
- Laboratory of Molecular Biology Applied to Mycobacteria, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Wânia da Silva Carvalho
- Laboratory of Molecular Biology and Public Health, Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Harrison Magdinier Gomes
- Laboratory of Molecular Biology Applied to Mycobacteria, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil.
| | - Isabela Neves de Almeida
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, Department of Internal medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Lida Jouca de Assis
- Laboratory of Molecular Biology and Public Health, Department of Social Pharmacy, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | | | - Michel Kireopori Gomgnimbou
- Institut for Integrative Cell Biology, I2BC, UMR9198 CEA-CNRS-UPSaclay, Orsay, France. .,Centre Muraz, Bobo-Dioulasso, Burkina Faso.
| | - Guislaine Refregier
- Institut for Integrative Cell Biology, I2BC, UMR9198 CEA-CNRS-UPSaclay, Orsay, France.
| | - Christophe Sola
- Institut for Integrative Cell Biology, I2BC, UMR9198 CEA-CNRS-UPSaclay, Orsay, France.
| | - Silvana Spíndola de Miranda
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, Department of Internal medicine, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
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Characterization of a Clone of Mycobacterium tuberculosis Clinical Isolates with Mutations in KatG (A110V), EthA (Q269STOP), and the inhA Promoter (-15C→T). J Clin Microbiol 2015; 53:3104. [PMID: 26157154 DOI: 10.1128/jcm.01537-15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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