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Shrestha A, Picoy J, Torres A, Moore DA, Gilman RH, Coronel J, Grandjean L. A case report of transmission and disease caused by Mycobacterium caprae and Mycobacterium bovis in Lima, Peru. BMC Infect Dis 2021; 21:1265. [PMID: 34930187 PMCID: PMC8686613 DOI: 10.1186/s12879-021-06944-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/03/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The Tuberculosis (TB) burden in Peru is significant with respect to both disease morbidity and mortality. Furthermore the recent diversification of farming enterprise to include a wide range of animal species has necessitated the consideration of members of the Mycobacterium Tuberculosis Complex (MTBC) with the potential for zoonotic transmission. M. bovis and M. caprae, a lesser known member of the MTBC exhibit an exceptionally wide host spectrum in animals and are capable of causing disease in humans. M. bovis has a predictable resistance profile which includes resistance to pyrazinamide. Thus, failure to identify M. bovis as the causative agent in reported TB cases leads to higher levels of treatment failure and contributes to the transmission of drug-resistant TB. CASE PRESENTATION Reported here are the clinical presentations, investigations and treatment histories of two patients identified from a population level genotyping study in Lima, Peru that were at the time of treatment thought to be M. tuberculosis patients but in retrospect were spectated using whole genome sequencing as M. caprae and M. Bovis. CONCLUSIONS The cases reported here constitute convincing evidence that M. caprae and M. bovis are causative agents of TB infection in humans in Peru and underscore the importance of species-level MTBC member identification to effectively control and treat zoonotic TB. Furthermore these cases highlight the challenges of using clinical risk factors to identify cases of zoonotic TB in humans as their clinical presentation and transmission history is often difficult to distinguish from anthroponotic TB.
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Affiliation(s)
- Amber Shrestha
- grid.420468.cDepartment of Infectious Disease, Great Ormond Street Hospital for Children, London, WC1N 3JH UK
| | - Janeth Picoy
- Department of Infectious Disease, Diresa Callao Jr, Colina #879, Bellavista, 07016 Lima, Peru
| | - Arturo Torres
- grid.7445.20000 0001 2113 8111Department of Infectious Disease, Imperial College London, South Kensington, London, SW7 2AZ UK
| | - David A. Moore
- grid.8991.90000 0004 0425 469XTB Centre, London School of Hygiene & Tropical Medicine, London, WC1E 7HT UK
| | - Robert H. Gilman
- grid.11100.310000 0001 0673 9488Laboratorio de Tuberculosis, Laboratorios de Investigación Y Desarrollo, Facultad de Ciencias Y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru ,grid.21107.350000 0001 2171 9311Department of International Health, School of Public Health, Johns Hopkins University, Baltimore, MD USA
| | - Jorge Coronel
- grid.11100.310000 0001 0673 9488Laboratorio de Investigación de Enfermedades Infecciosas, Universidad Peruana Cayetano Heredia: Lima, Lima, Peru
| | - Louis Grandjean
- Department of Infectious Disease, Great Ormond Street Hospital for Children, London, WC1N 3JH, UK. .,University College London, Gower St, Bloomsbury, London, WC1E 6BT, UK.
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2
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Oudghiri A, Momen G, Aainouss A, Laglaoui A, El Messaoudi MD, El Mzibri M, Chaoui I. Genotypic diversity of multi- and pre-extremely drug-resistant Mycobacterium tuberculosis isolates from Morocco. PLoS One 2021; 16:e0253826. [PMID: 34214120 PMCID: PMC8253442 DOI: 10.1371/journal.pone.0253826] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/13/2021] [Indexed: 12/02/2022] Open
Abstract
In Morocco, the prevalence of multidrug resistant tuberculosis (MDR-TB) continues to increase especially within previously treated cases; these MDR cases may evolve to extensively drug resistant tuberculosis (XDR-TB) raising major concern to TB control programs. From an epidemiological window, scarce informations are available about the genetic diversity of Mycobacterium tuberculosis (MTB) strains fueling these forms of resistance. The aim of this study was to assess to genetic diversity of MDR-MTB strains. Hence, this prospective study was conducted on patients diagnosed with MDR-TB at Pasteur Institute of Casablanca from 2010 to 2013. A total of 70 MDR-MTB isolates were genotyped by spoligotyping and 15-loci MIRU-VNTR methods. Spoligotyping generated four orphan patterns, five unique profiles whereas 61 strains were grouped in nine clusters (2 to 25 strains per cluster), the clustering rates being 87.1%. Subtyping by 15 loci MIRU-VNTR splitted all clusters already established by spoligotyping and generated 70 unique profiles not recognized in SITVIT2 database; clustering rate was equal to zero. HGDI analysis of 15 loci MIRU demonstrated that eight out of 15 loci were highly discriminant. Of note, all pre-XDR strains belongs to many clades, meaning that there no association between gyrA mutants and particular clade. Overall, the data generated by this study (i) describe the population structure of MDR MTBC in Morocco which is highly homogenous, (ii) confirm that TB in Morocco is almost exclusively transmitted by modern and evolutionary lineages with high level of biodiversity seen by MIRU, and (iii) validate the use of optimized 15-loci MIRU-VNTR format for future investigations in Morocco.
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Affiliation(s)
- Amal Oudghiri
- Department of Life Sciences, Medical and Biological Research Unit, National Center of Energy, Sciences and Nuclear Techniques, Rabat, Morocco
- Faculty of Sciences and Techniques, Biotechnology and Bimolecular Engineering Research Laboratory, Tangier, Morocco
| | - Ghizlane Momen
- Laboratory of Mycabacteria, Pasteur Institute of Morocco, Casablanca, Morocco
- Faculty of Sciences, Laboratory of Microbiology Pharmacology, Biotechnology and Environment, Casablanca, Morocco
| | - Achraf Aainouss
- Laboratory of Mycabacteria, Pasteur Institute of Morocco, Casablanca, Morocco
- Faculty of Sciences Ben M’Sik, Laboratory of Ecology and Environment, Casablanca, Morocco
| | - Amin Laglaoui
- Faculty of Sciences and Techniques, Biotechnology and Bimolecular Engineering Research Laboratory, Tangier, Morocco
| | | | - Mohammed El Mzibri
- Department of Life Sciences, Medical and Biological Research Unit, National Center of Energy, Sciences and Nuclear Techniques, Rabat, Morocco
| | - Imane Chaoui
- Department of Life Sciences, Medical and Biological Research Unit, National Center of Energy, Sciences and Nuclear Techniques, Rabat, Morocco
- * E-mail: ,
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3
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Momen G, Aainouss A, Lamaammal A, Chettioui F, Blaghen M, Messoudi M, Belghmi K, Mouslim J, El Mzibri M, El Messaoudi MD, Khyatti M, Chaoui I. Molecular characterization of mutations associated with resistance to second line drugs in Mycobacterium tuberculosis patients from Casablanca, Morocco. Rev Inst Med Trop Sao Paulo 2021; 63:e19. [PMID: 33787739 PMCID: PMC7997671 DOI: 10.1590/s1678-9946202163019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 01/22/2021] [Indexed: 12/02/2022] Open
Abstract
The emergence and spread of extensively drug-resistant tuberculosis (XDR-TB) is a
serious threat to global health. Therefore, its rapid diagnosis is crucial. The
present study aimed to characterize mutations conferring resistance to second
line drugs (SLDs) within multidrug Mycobacterium tuberculosis
(MDR-MTB) isolates and to estimate the occurrence of XDR-TB in Casablanca,
Morocco. A panel of 200 MDR-TB isolates was collected at the Pasteur Institute
between 2015-2018. Samples were subjected to drug susceptibility testing to
Ofloxacin (OFX), Kanamycin (KAN) and Amikacin (AMK). The mutational status of
gyrA, gyrB, rrs,
tlyA and eis was assessed by sequencing
these target genes. Drug susceptibility testing for SLDs showed that among the
200 MDR strains, 20% were resistant to OFX, 2.5% to KAN and 1.5% to AMK.
Overall, 14.5% of MDR strains harbored mutations in gyrA,
gyrB, rrs and tlyA genes.
From the 40 OFXR isolates, 67.5% had mutations in QRDR of
gyrA and gyrB genes, the most frequent one
being Ala90Val in gyrA gene. Of note, none of the isolates
harbored simultaneously mutations in gyrA and
gyrB genes. In eight out of the 200 MDR-TB isolates
resistant either to KAN or AMK, only 25% had A1401G or Lys89Glu change in
rrs and tlyA genes respectively. This
study is very informative and provides data on the alarming rate of
fluoroquinolone resistance which warrants the need to implement appropriate drug
regimens to prevent the emergence and spread of more severe forms of
Mycobacterium tuberculosis drug resistance.
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Affiliation(s)
- Ghizlane Momen
- Institut Pasteur du Maroc, Laboratoire des Mycobactéries, Casablanca, Morocco.,Faculté des Sciences, Laboratoire de Microbiologie, Pharmacologie, Biotechnologie et Environnement, Casablanca, Morocco
| | - Achraf Aainouss
- Institut Pasteur du Maroc, Laboratoire des Mycobactéries, Casablanca, Morocco.,Faculté des Sciences Ben M'Sik, Laboratoire d'Ecologie et Environment, Casablanca, Morocco
| | | | - Fouad Chettioui
- Institut Pasteur du Maroc, Laboratoire des Mycobactéries, Casablanca, Morocco
| | - Mohamed Blaghen
- Faculté des Sciences, Laboratoire de Microbiologie, Pharmacologie, Biotechnologie et Environnement, Casablanca, Morocco
| | - Malika Messoudi
- Institut Pasteur du Maroc, Laboratoire des Mycobactéries, Casablanca, Morocco
| | - Khalid Belghmi
- Institut Pasteur du Maroc, Laboratoire des Mycobactéries, Casablanca, Morocco
| | - Jamal Mouslim
- Faculté des Sciences Ben M'Sik, Laboratoire d'Ecologie et Environment, Casablanca, Morocco
| | - Mohammed El Mzibri
- Centre National de l'Energie, des Sciences et Techniques Nucléaires, Département des Sciences du Vivant, Unité de Recherches Médicales et Biologiques, Rabat, Morocco
| | | | - Meriem Khyatti
- Institut Pasteur du Maroc, Laboratoire des Mycobactéries, Casablanca, Morocco
| | - Imane Chaoui
- Centre National de l'Energie, des Sciences et Techniques Nucléaires, Département des Sciences du Vivant, Unité de Recherches Médicales et Biologiques, Rabat, Morocco
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4
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Abascal E, Pérez-Lago L, Martínez-Lirola M, Chiner-Oms Á, Herranz M, Chaoui I, Comas I, El Messaoudi MD, Cárdenas JAG, Santantón S, Bouza E, García-de-Viedma D. Whole genome sequencing-based analysis of tuberculosis (TB) in migrants: rapid tools for cross-border surveillance and to distinguish between recent transmission in the host country and new importations. ACTA ACUST UNITED AC 2020; 24. [PMID: 30696526 PMCID: PMC6351995 DOI: 10.2807/1560-7917.es.2019.24.4.1800005] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background The analysis of transmission of tuberculosis (TB) is challenging in areas with a large migrant population. Standard genotyping may fail to differentiate transmission within the host country from new importations, which is key from an epidemiological perspective. Aim To propose a new strategy to simplify and optimise cross-border surveillance of tuberculosis and to distinguish between recent transmission in the host country and new importations Methods We selected 10 clusters, defined by 24-locus mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR), from a population in Spain rich in migrants from eastern Europe, north Africa and west Africa and reanalysed 66 isolates by whole-genome sequencing (WGS). A multiplex-allele-specific PCR was designed to target strain-specific marker single nucleotide polymorphisms (SNPs), identified from WGS data, to optimise the surveillance of the most complex cluster. Results In five of 10 clusters not all isolates showed the short genetic distances expected for recent transmission and revealed a higher number of SNPs, thus suggesting independent importations of prevalent strains in the country of origin. In the most complex cluster, rich in Moroccan cases, a multiplex allele-specific oligonucleotide-PCR (ASO-PCR) targeting the marker SNPs for the transmission subcluster enabled us to prospectively identify new secondary cases. The ASO-PCR-based strategy was transferred and applied in Morocco, demonstrating that the strain was prevalent in the country. Conclusion We provide a new model for optimising the analysis of cross-border surveillance of TB transmission in the scenario of global migration.
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Affiliation(s)
- Estefanía Abascal
- These authors have contributed equally.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Servicio Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Laura Pérez-Lago
- These authors have contributed equally.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Servicio Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Álvaro Chiner-Oms
- Unidad Mixta Genómica y Salud, Centro Superior de Investigación en Salud Pública (FISABIO)-Universitat de València, Valencia, Spain
| | - Marta Herranz
- CIBER Enfermedades respiratorias (CIBERES), Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Servicio Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Imane Chaoui
- Unité de Biologie et Recherches Médicales, Division des Sciences du Vivant, Centre National de l'Energie, des Sciences et des Techniques Nucléaires (CNESTEN), Rabat, Morocco
| | - Iñaki Comas
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain.,Instituto de Biomedicina de Valencia (IBV) Consejo Superior de Investigaciones Científicas (CSIC), Valencia, Spain
| | | | | | - Sheila Santantón
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Servicio Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilio Bouza
- Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.,CIBER Enfermedades respiratorias (CIBERES), Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Servicio Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Darío García-de-Viedma
- CIBER Enfermedades respiratorias (CIBERES), Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Servicio Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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5
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Kone B, Somboro AM, Holl JL, Baya B, Togo AACG, Sarro YDS, Diarra B, Kodio O, Murphy RL, Bishai W, Maiga M, Doumbia S. Exploring the usefulness of molecular epidemiology of tuberculosis in Africa: a systematic review. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2020; 11:1-15. [PMID: 32714498 PMCID: PMC7373718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/05/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Tuberculosis (TB) is caused by Mycobacterium tuberculosis complex (MTBC) and remains a serious global public health threat, especially in resource-limited settings such as the African region. Recent developments in molecular epidemiology tools have significantly improved our understanding of TB transmission patterns and revealed the high genetic diversity of TB isolates across geographical entities in Africa. This study reports the results of a systematic review of current knowledge about MTBC strain diversity and geographical distribution in African regions. METHODS Search tools (PubMed, Embase, Popline, OVID and Africa Wide Information) were employed to identify the relevant literature about prevalence, strain diversity, and geographic distribution of MTBC infection in Africa. RESULTS A total of 59 articles from 739 citations met our inclusion criteria. Most articles reported about patients with presumptive pulmonary TB (73%), fewer reports were on retreatment and treatment failure cases (12%), and presumptive drug resistance cases (3%). Spoligotyping was the most used, alone in 21 studies and in parallel with either the Mycobacterial Interspersed Repetitive Units Variable Number of Tandem Repeats or the Restriction Fragment Length Polymorphism. Various TB lineages were observed across the African continent, with the originally European lineage 4 spotted in all countries studied. CONCLUSION TB molecular epidemiology tools have substantially improved our understanding of the MTBC circulating isolates, their evolution, and diversity in this highly endemic region of Africa. We found that only TB lineage 4 is present throughout all the continent and the clusters identified provides an extended insight into the disease transmission dynamics.
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Affiliation(s)
- Bourahima Kone
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
| | - Anou M Somboro
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
- Medical Biochemistry, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-NatalDurban, South Africa
| | | | - Bocar Baya
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
| | - Antieme ACG Togo
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
| | - Yeya Dit Sadio Sarro
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
| | - Bassirou Diarra
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
| | - Ousmane Kodio
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
| | - Robert L Murphy
- Institute for Global Health, Northwestern UniversityChicago, Illinois, USA
| | - William Bishai
- Center for TB Research, Johns Hopkins UniversityBaltimore, MD, USA
| | - Mamoudou Maiga
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
- Institute for Global Health, Northwestern UniversityChicago, Illinois, USA
| | - Seydou Doumbia
- University Clinical Research Center (UCRC)-SEREFO, University of Sciences, Techniques and Technologies of Bamako (USTTB)Bamako, Mali
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6
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Mogashoa T, Melamu P, Ley SD, Streicher EM, Iketleng T, Kelentse N, Mupfumi L, Mokomane M, Kgwaadira B, Novitsky V, Kasvosve I, Moyo S, Warren RM, Gaseitsiwe S. Genetic diversity of Mycobacterium tuberculosis strains circulating in Botswana. PLoS One 2019; 14:e0216306. [PMID: 31063472 PMCID: PMC6504092 DOI: 10.1371/journal.pone.0216306] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/17/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Molecular typing of Mycobacterium tuberculosis (M.tb) isolates can inform Tuberculosis (TB) control programs on the relative proportion of transmission driving the TB epidemic. There is limited data on the M. tb genotypes that are circulating in Botswana. The aim of this study was to generate baseline data on the genetic diversity of M.tb isolates circulating in the country. METHODS A total of 461 M.tb isolates received at the Botswana National Tuberculosis Reference Laboratory between March 2012 and October 2013 were included in this study. Drug susceptibility testing was conducted using the BD BACTEC MGIT 960 System. M.tb strains were genotyped using spoligotyping and spoligotype patterns were compared with existing patterns in the SITVIT Web database. A subset of drug resistant isolates which formed spoligo clusters (n = 65) was additionally genotyped with 12-loci MIRU. Factors associated with drug resistance and clustering were evaluated using logistic regression. RESULTS Of the 461 isolates genotyped, 458 showed 108 distinct spoligotype patterns. The predominant M.tb lineages were Lineage 4 (81.9%), Lineage 2 (9%) and Lineage 1 (7.2%). The predominant spoligotype families within Lineage 4 were LAM (33%), S (14%), T (16%), X (16%). Three hundred and ninety-two (86%) isolates could be grouped into 44 clusters (2-46 isolates per cluster); giving a clustering rate of 76%. We identified 173 (37.8%) drug resistant isolates, 48 (10.5%) of these were multi-drug resistant. MIRU typing of the drug resistant isolates allowed grouping of 46 isolates into 14 clusters, giving a clustering rate of 49.2%. There was no association between age, sex, treatment category, region and clustering. CONCLUSIONS This study highlights the complexity of the TB epidemic in Botswana with multiple strains contributing to disease and provides baseline data on the population structure of M.tb strains in Botswana.
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Affiliation(s)
- Tuelo Mogashoa
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Pinkie Melamu
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Serej D. Ley
- DST-NRF Centre of Excellence in Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Elizabeth M. Streicher
- DST-NRF Centre of Excellence in Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Thato Iketleng
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- College of Health Sciences, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa
| | | | - Lucy Mupfumi
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Margaret Mokomane
- National Tuberculosis Reference Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | - Botshelo Kgwaadira
- National Tuberculosis Reference Laboratory, Ministry of Health and Wellness, Gaborone, Botswana
| | - Vladimir Novitsky
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Ishmael Kasvosve
- Department of Medical Laboratory Sciences, Faculty of Health Sciences, University of Botswana, Gaborone, Botswana
| | - Sikhulile Moyo
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Robin M. Warren
- DST-NRF Centre of Excellence in Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Simani Gaseitsiwe
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
- * E-mail: ,
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7
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Panossian B, Salloum T, Araj GF, Khazen G, Tokajian S. First insights on the genetic diversity of MDR Mycobacterium tuberculosis in Lebanon. BMC Infect Dis 2018; 18:710. [PMID: 30594126 PMCID: PMC6311033 DOI: 10.1186/s12879-018-3626-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/17/2018] [Indexed: 11/24/2022] Open
Abstract
Background Lebanon hosts a heterogeneous population coming from underdeveloped and developing countries, resulting in increasing incidences of tuberculosis over the past years. The genetic heterogeneity and lineages associated with tuberculosis, along with their resistance determinants have not been studied at the genomic level previously in the region. Methods Isolates were recovered from the American University of Beirut Medical Center (AUBMC). Antimicrobial susceptibility profiles were determined using the MGIT automated system for the first-line drugs at AUBMC, while second-line drug susceptibility was tested at Mayo Clinic Laboratories. Whole Genome Sequencing (WGS) was performed to classify mycobacterial lineages and highlight single nucleotide mutations causing resistance to both 1st line and 2nd line antimicrobials. wgSNP analysis provided insights on the phylogeny of the isolates along with spoligotyping and core genomic SNVs, IS6110 insertion sites, and variable number tandem repeats (VNTR). Results The analyzed isolates carry distinct resistance determinants to isoniazid, rifampicin, ethambutol, quinolones, and streptomycin. The isolates belonged to different lineages including the Euro/American lineage (Lineage 4) (53.8%), M. bovis (15.4%) and Delhi/Central Asia (Lineage 1) (15.4%), Beijing/East Asia (Lineage 2) (7.7%), and East Africa/Indian Ocean lineage (Lineage 3) (7.7%) showing great phylogenetic differences at the genomic level. Conclusions The population diversity in Lebanon holds an equally diverse and uncharacterized population of drug resistant mycobacteria. To achieve the WHO “END-TB” milestones of 2025 and 2035, Lebanon must decrease TB incidences by 95% in the next decade. This can only be done through WGS-based patient centered diagnosis with higher throughput and genomic resolution to improve treatment outcomes and to monitor transmission patterns. Electronic supplementary material The online version of this article (10.1186/s12879-018-3626-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Balig Panossian
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos Campus, P.O. Box 36, Byblos, Lebanon
| | - Tamara Salloum
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos Campus, P.O. Box 36, Byblos, Lebanon
| | - George F Araj
- Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Georges Khazen
- Department of Computer Science and Mathematics, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Sima Tokajian
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Byblos Campus, P.O. Box 36, Byblos, Lebanon.
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8
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Hoffner S, Sahebi L, Ansarin K, Sabour S, Mohajeri P. Mycobacterium tuberculosis of the Beijing Genotype in Iran and the World Health Organization Eastern Mediterranean Region: A Meta-Analysis. Microb Drug Resist 2017; 24:693-698. [PMID: 29058526 DOI: 10.1089/mdr.2017.0160] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE The Beijing genotype is a distinct genetic lineage of Mycobacterium tuberculosis, which is distributed worldwide, and may cause large outbreaks of multidrug resistance-tuberculosis (MDR-TB). The distribution of such strains in the Eastern Mediterranean region (EMR) is unclear, and clarifying the data is our purpose apart from the presence of Beijing TB in Iran. METHODS We searched Published literature from CINAHL Cochrane Library, Current Contents, Database of Abstracts of Reviews of Effects (DARE), ProQuest Google Scholar PubMed, PsycINFO, Thomson Reuters, (SID), and Medical Library (MedLib) to detect relevant studies from the year 2000 to July 2015 with the following keywords: M. tuberculosis, Beijing genotype, EMR, and drug resistance. Random-effect models were used to estimate the proportion of Beijing strains in STATA 14. Heterogeneity was investigated by subgroup analysis and meta-regression. RESULTS AND CONCLUSION The meta-prevalence of Beijing strains was 4% (CI 95% = 3-5). The prevalence was different based on types of detection techniques (spoligotyping = 4% vs. other techniques = 6%; p = 0.003) and years of study (before the year 2000 = 2% vs. after year 2000 = 4%, p = 0.004). The Beijing family was most prevalent in Iran and Pakistan. A strong relationship with drug resistance was reported in Pakistan and Iran, and an increasing trend was seen in Pakistan. Additional studies of drug-resistant TB distribution among Beijing strains in EMR countries are needed as well as a time-trend analysis of the Beijing strain infection in the region.
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Affiliation(s)
- Sven Hoffner
- 1 Department of Microbiology, Tumor and Cell Biology (MTC), Karolinska Institutet , Stockholm, Sweden
| | - Leyla Sahebi
- 2 Maternal/Fetal and Neonatal Research Center, Tehran University of Medical Sciences , Tehran, Iran .,3 Department of Epidemiology, Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Science , Tabriz, Iran
| | - Khalil Ansarin
- 4 Department of Medicine, Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Siamak Sabour
- 5 Department of Clinical Epidemiology, Safety Promotion and Injury Prevention Research Center, School of Health, Shahid Beheshti University of Medical Sciences , Tehran, Iran
| | - Parviz Mohajeri
- 6 Department of Microbiology, Faculty of Medicine, Kermanshah University of Medical Sciences , Kermanshah, Iran
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9
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Mycobacterium tuberculosis genotypes and predominant clones among the multidrug-resistant isolates in Spain 1998-2005. INFECTION GENETICS AND EVOLUTION 2017; 55:117-126. [PMID: 28789982 DOI: 10.1016/j.meegid.2017.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 07/31/2017] [Accepted: 08/03/2017] [Indexed: 11/23/2022]
Abstract
Although the incidence of tuberculosis (TB) is gradually decreasing in Spain, there is an increase in the proportion of foreign-born cases. This changing scenario is slowly shifting the local TB epidemiology from endemic to imported cases with an increased risk for multidrug-resistant (MDR) and extensively drug resistant (XDR) strains of Mycobacterium tuberculosis complex. MDR/XDR strains from Spain (n=366 MTBC isolates, 1 strain per patient) isolated between 1998 and 2005 were retained for this retrospective analysis. All strains were analyzed by spoligotyping, while 12-loci MIRU-VNTR data were available for 106 isolates from 2003 to 2005. Demographic, phylogenetic, and epidemiologic analyses using anonymized data were collected and analyzed using the SITVIT2 database. Our study provides with a first snapshot of genetic diversity of MDR/XDR-TB in several autonomous regions of Spain. It highlights significantly more of SIT1/Beijing and SIT66/BOV MDR isolates (5.7% and 7.38% respectively) and increasingly more foreign-born cases from Eastern Europe. Future studies should focus on shared genotypes between Spanish and foreign-born patients to decipher the modes of transmission and risk factors involved, and decipher the proportion of imported cases of active disease versus cases of reactivation of latent TB infection among foreign-born individuals.
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10
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Ennassiri W, Jaouhari S, Cherki W, Charof R, Filali-Maltouf A, Lahlou O. Extensively drug-resistant tuberculosis (XDR-TB) in Morocco. J Glob Antimicrob Resist 2017; 11:75-80. [PMID: 28743645 DOI: 10.1016/j.jgar.2017.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/25/2017] [Accepted: 07/12/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Extensively drug-resistant tuberculosis (XDR-TB) has recently been identified as a major global health threat. The aim of this study was to evaluate the presence of XDR-TB among Mycobacterium tuberculosis isolates in Morocco and its association with demographic, clinical and epidemiological features. METHODS A total of 524 patients from the Moroccan National Tuberculosis Reference Laboratory, representative of all of the geographic regions, were subject to first-line drug susceptibility testing (DST). Subsequently, 155 isolates found to be multidrug-resistant tuberculosis (MDR-TB) underwent second-line DST. Moreover, to enhance our understanding of the genetic basis of these drug-resistant strains, drug resistance-associated mutations were investigated in isolates either identified as pre-XDR- and XDR-TB or suspected resistant using the GenoType® MTBDRsl V1.0 assay. RESULTS In this study, 4 (2.6%) XDR-TB and 18 (11.6%) pre-XDR-TB isolates were identified. Agreement between the MTBDRsl assay results and phenotypic DST was 95.2% for ofloxacin, 81.0% for kanamycin and 95.2% for amikacin. CONCLUSIONS To the best of our knowledge, this is the first study to evaluate the frequency of XDR-TB in Morocco. These results highlight the need to reinforce the TB management policy in Morocco with regard to control and detection strategies in order to prevent further spread of XDR-TB isolates.
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Affiliation(s)
- Wifak Ennassiri
- Laboratory of Microbiology and Molecular Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco; National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco
| | - Sanae Jaouhari
- National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco
| | - Wafa Cherki
- National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco
| | - Reda Charof
- National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco
| | - Abdelkarim Filali-Maltouf
- Laboratory of Microbiology and Molecular Biology, Faculty of Sciences, Mohammed V University, Rabat, Morocco
| | - Ouafae Lahlou
- National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco.
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11
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Annotated Whole-Genome Shotgun Sequence of Multidrug-Resistant Mycobacterium tuberculosis MTB13_M Isolated from Morocco. GENOME ANNOUNCEMENTS 2017; 5:5/9/e01756-16. [PMID: 28254964 PMCID: PMC5334602 DOI: 10.1128/genomea.01756-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Here, we describe the annotated genome sequence of Mycobacterium tuberculosis MTB13_M. The organism was isolated from a sputum sample in Morocco.
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El Mrini M, Kichou F, Kadiri A, Berrada J, Bouslikhane M, Cordonnier N, Romero B, Gortázar C. Animal tuberculosis due to Mycobacterium bovis in Eurasian wild boar from Morocco. EUR J WILDLIFE RES 2016. [DOI: 10.1007/s10344-016-1022-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Nebreda T, Álvarez-Prida E, Blanco B, Remacha MA, Samper S, Jiménez MS. Peritoneal tuberculosis due to Mycobacterium caprae. IDCases 2016; 4:50-2. [PMID: 27134824 PMCID: PMC4833828 DOI: 10.1016/j.idcr.2016.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 02/24/2016] [Accepted: 02/24/2016] [Indexed: 11/16/2022] Open
Abstract
The incidence of tuberculosis in humans due to Mycobacterium caprae is very low and is almost confined to Europe. We report a case of a previously healthy 41-year-old Moroccan with a 6 month history of abdominal pain, weight loss, fatigue and diarrhea. A diagnosis of peritoneal tuberculosis due to M. caprae was made.
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Affiliation(s)
- T Nebreda
- Servicio de Microbiología, Complejo Asistencial Universitario de León, León, Spain
| | - E Álvarez-Prida
- Servicio de Cirugía General, Complejo Asistencial Universitario de León, León, Spain
| | - B Blanco
- Servicio de Medicina Interna, Complejo Asistencial Universitario de León, León, Spain
| | - M A Remacha
- Servicio de Microbiología, Complejo Asistencial Universitario de León, León, Spain
| | - S Samper
- Instituto de Investigación Sanitaria Aragón, Instituto Aragonés de Ciencias de la Salud, Consorcio Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Zaragoza, Spain
| | - M S Jiménez
- Centro Nacional de Microbiología, Instituto Carlos III, Majadahonda, Madrid, Spain
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14
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Diab HM, Nakajima C, Kotb SA, Mokhtar A, Khder NFM, Abdelaal ASA, Hegazy A, Poudel A, Shah Y, Suzuki Y. First insight into the genetic population structure of Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients in Egypt. Tuberculosis (Edinb) 2015; 96:13-20. [PMID: 26786649 DOI: 10.1016/j.tube.2015.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 10/31/2015] [Accepted: 11/08/2015] [Indexed: 11/19/2022]
Abstract
The present study aimed to assess the population structure of Mycobacterium tuberculosis (MTB) isolates from Egypt. A total of 230 MTB isolates were analysed using spoligotyping, large sequence polymorphism (LSPs), mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing and multi-locus sequence typing (MLST). The majority of isolates (93.0%) belonged to lineage 4, including 44.3, 13.4 and 10.8% of the ill-defined T clade, LAM and Haarlem families, respectively, and lineage 3 was identified in 7.0% of the isolates. MIRU-VNTRs typing allowed efficient discrimination of the spoligotype-defined clusters, including spoligo-international types (SIT) 53, 34, and 4, into 56 patterns, including 13 clusters and 43 unique patterns. A new SNP at position 311614 was identified in all six isolates to form the biggest MIRU-VNTR cluster, which suggested a recent clonal expansion. This SNP could possibly be used as a genetic marker for robust discriminations of Egyptian MTB isolates belonging to SIT53. The combination of spoligotyping, 12 MIRU-VNTRs loci and MLST provided insight into the genetic diversity and transmission dynamics of the Egyptian MTB genotypes and could be a key to implementation of effective control measures by public health authorities.
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Affiliation(s)
- Hassan Mahmoud Diab
- Department of Animal Hygiene, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt; Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan
| | - Chie Nakajima
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Hokkaido University, The Global Station for Zoonosis Control, Sapporo, Japan
| | - Saber A Kotb
- Department of Animal Hygiene, Faculty of Veterinary Medicine, Assiut University, Egypt
| | - Alaa Mokhtar
- National Tuberculosis Control Program, Ministry of Health and Population, Egypt
| | - Nagwa F M Khder
- TB Supranational Reference Laboratory, Central Public Health Laboratories, Clinical Microbiology Department, Ministry of Health and Population, Egypt
| | - Ahmed S A Abdelaal
- TB Supranational Reference Laboratory, Central Public Health Laboratories, Clinical Microbiology Department, Ministry of Health and Population, Egypt
| | - Azza Hegazy
- TB Supranational Reference Laboratory, Central Public Health Laboratories, Clinical Microbiology Department, Ministry of Health and Population, Egypt
| | - Ajay Poudel
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan
| | - Yogendra Shah
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan
| | - Yasuhiko Suzuki
- Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; Hokkaido University, The Global Station for Zoonosis Control, Sapporo, Japan.
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15
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Genetic Diversity of Mycobacterium tuberculosis Complex Isolated from Tuberculosis Patients in Bahir Dar City and Its Surroundings, Northwest Ethiopia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:174732. [PMID: 26491657 PMCID: PMC4600926 DOI: 10.1155/2015/174732] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 08/08/2015] [Accepted: 08/17/2015] [Indexed: 11/17/2022]
Abstract
The knowledge of the diversity of strains of Mycobacterium tuberculosis complex (MTBC) species in a specific geographical region can contribute to the control of tuberculosis (TB). This study was conducted to identify the MTBC isolates to the species and spoligotype international type (SIT) level by spoligotyping. A total of 168 MTBC isolates were recovered from TB patients, spoligotyped, and their patterns were compared with those of the strains registered in the SITVIT2 database. Of 168 isolates spoligotyped, 89 patterns were identified. Ninety-eight isolates were clustered into 19 strain groups with clustering percentage of 58.3%. Forty-four strains matched the preexisting SITs in the SITVIT2 database. The dominant strains were SIT289, SIT134, and SIT3411, comprising 16.7% (28/168), 7.14% (12/168), and 4.76% (8/168) of the isolates, respectively. Euro-American (51.2%), East-African-Indian (34.5%), and M. africanum (9.52%) were the major lineages identified. Two strains of M. bovis were isolated from TB lymphadenitis cases. The high percentage of clustered strains of M. tuberculosis could suggest that a small number of lineages of M. tuberculosis are causing the disease in the area while isolation of M. bovis could suggest its zoonotic potential. Additionally, identification of M. africanum requires further confirmation by tools with a better discriminatory power.
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16
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Bouklata N, Supply P, Jaouhari S, Charof R, Seghrouchni F, Sadki K, El Achhab Y, Nejjari C, Filali-Maltouf A, Lahlou O, El Aouad R. Molecular Typing of Mycobacterium Tuberculosis Complex by 24-Locus Based MIRU-VNTR Typing in Conjunction with Spoligotyping to Assess Genetic Diversity of Strains Circulating in Morocco. PLoS One 2015; 10:e0135695. [PMID: 26285026 PMCID: PMC4540494 DOI: 10.1371/journal.pone.0135695] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 07/26/2015] [Indexed: 01/27/2023] Open
Abstract
Background Standard 24-locus Mycobacterial Interspersed Repetitive Unit Variable Number Tandem Repeat (MIRU-VNTR) typing allows to get an improved resolution power for tracing TB transmission and predicting different strain (sub) lineages in a community. Methodology During 2010–2012, a total of 168 Mycobacterium tuberculosis Complex (MTBC) isolates were collected by cluster sampling from 10 different Moroccan cities, and centralized by the National Reference Laboratory of Tuberculosis over the study period. All isolates were genotyped using spoligotyping, and a subset of 75 was genotyped using 24-locus based MIRU-VNTR typing, followed by first line drug susceptibility testing. Corresponding strain lineages were predicted using MIRU-VNTRplus database. Principal Findings Spoligotyping resulted in 137 isolates in 18 clusters (2–50 isolates per cluster: clustering rate of 81.54%) corresponding to a SIT number in the SITVIT database, while 31(18.45%) patterns were unique of which 10 were labelled as “unknown” according to the same database. The most prevalent spoligotype family was LAM; (n = 81 or 48.24% of isolates, dominated by SIT42, n = 49), followed by Haarlem (23.80%), T superfamily (15.47%), >Beijing (2.97%), > U clade (2.38%) and S clade (1.19%). Subsequent 24-Locus MIRU-VNTR typing identified 64 unique types and 11 isolates in 5 clusters (2 to 3isolates per cluster), substantially reducing clusters defined by spoligotyping only. The single cluster of three isolates corresponded to two previously treated MDR-TB cases and one new MDR-TB case known to be contact a same index case and belonging to a same family, albeit residing in 3 different administrative regions. MIRU-VNTR loci 4052, 802, 2996, 2163b, 3690, 1955, 424, 2531, 2401 and 960 were highly discriminative in our setting (HGDI >0.6). Conclusions 24-locus MIRU-VNTR typing can substantially improve the resolution of large clusters initially defined by spoligotyping alone and predominating in Morocco, and could therefore be used to better study tuberculosis transmission in a population-based, multi-year sample context.
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Affiliation(s)
- Nada Bouklata
- National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco
- Laboratory of Microbiology and Molecular Biology, Faculty of Sciences, University Mohammed V, Rabat, Morocco
- * E-mail:
| | - Philip Supply
- INSERMU1018, Lille, France
- CNRS UMR8204, Lille, France
- Center for Infection and Immunity of Lille (CIIL), Institut Pasteur de Lille, France
- Université de Lille, Lille, France
- Genoscreen, Lille, France
| | - Sanae Jaouhari
- National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco
| | - Reda Charof
- National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco
| | - Fouad Seghrouchni
- Laboratory of Cell Immunology, Department of Immunology, National Institute of Hygiene, Rabat, Morocco
| | - Khalid Sadki
- Laboratory of Microbiology and Molecular Biology, Faculty of Sciences, University Mohammed V, Rabat, Morocco
| | - Youness El Achhab
- Department of Epidemiology and Public Health, Faculty of Medicine and Pharmacy of Fes, Sidi Mohamed Ben Abdillah University, Fes, Morocco
| | - Chakib Nejjari
- Department of Epidemiology and Public Health, Faculty of Medicine and Pharmacy of Fes, Sidi Mohamed Ben Abdillah University, Fes, Morocco
| | - Abdelkarim Filali-Maltouf
- Laboratory of Microbiology and Molecular Biology, Faculty of Sciences, University Mohammed V, Rabat, Morocco
| | - Ouafae Lahlou
- National Tuberculosis Reference Laboratory, National Institute of Hygiene, Rabat, Morocco
| | - Rajae El Aouad
- School of Public Health and Management System Health, University Mohamed VI of Sciences and Health, Casablanca, Morocco
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17
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Prodinger WM, Indra A, Koksalan OK, Kilicaslan Z, Richter E. Mycobacterium caprae infection in humans. Expert Rev Anti Infect Ther 2014; 12:1501-13. [PMID: 25345680 DOI: 10.1586/14787210.2014.974560] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Mycobacterium caprae, a member of the Mycobacterium tuberculosis complex, causes tuberculosis (TB) in man and animals. Some features distinguish M. caprae from its epidemiological twin, Mycobacterium bovis: M. caprae is evolutionarily older, accounts for a smaller burden of zoonotic TB and is not globally distributed, but primarily restricted to European countries. M. caprae occurs only in a low proportion of human TB cases and this proportion may even decrease, if progress toward eradication of animal TB in Europe continues. So why bother, if M. caprae is not an enigma for diagnostic TB tests and if resistance against first-line drugs is a rarity with M. caprae? This 'European' pathogen of zoonotic TB asks interesting questions regarding the definition of a species. The latter, seemingly only an academic question, particularly requires and challenges the collaboration between human and veterinary medicine.
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Affiliation(s)
- Wolfgang M Prodinger
- Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Schoepfstrasse 41, 6020 Austria
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18
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Detection of Mycobacterium bovis in bovine and bubaline tissues using nested-PCR for TbD1. PLoS One 2014; 9:e91023. [PMID: 24618787 PMCID: PMC3949733 DOI: 10.1371/journal.pone.0091023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 02/06/2014] [Indexed: 11/20/2022] Open
Abstract
In the present study, a nested-PCR system, targeting the TbD1 region, involving the performance of conventional PCR followed by real-time PCR, was developed to detect Mycobacterium bovis in bovine/bubaline tissue homogenates. The sensitivity and specificity of the reactions were assessed with DNA samples extracted from tuberculous and non-tuberculous mycobacteria, as well as other actinomycetales species and DNA samples extracted directly from bovine and bubaline tissue homogenates. In terms of analytical sensitivity, the DNA of M. bovis AN5 was detected up to 1.56 ng with conventional PCR, 97.6 pg with real-time PCR, and 1.53 pg with nested-PCR in the reaction mixture. The nested-PCR exhibited 100% analytical specificity for M. bovis when tested with the DNA of reference strains of environmental mycobacteria and closely-related Actinomycetales. A clinical sensitivity value of 76.0% was detected with tissue samples from animals that exhibited positive results in the comparative intradermal tuberculin test (CITT), as well as from those with lesions compatible with tuberculosis (LCT) that rendered positive cultures. A clinical specificity value of 100% was detected with tissue samples from animals with CITT- results, with no visible lesions (NVL) and negative cultures. No significant differences were found between the nested-PCR and culture in terms of detecting CITT+ animals with LCT or with NVL. No significant differences were recorded in the detection of CITT- animals with NVL. However, nested-PCR detected a significantly higher number of positive animals than the culture in the group of animals exhibiting LCT with no previous records of CITT. The use of the nested-PCR assay to detect M. bovis in tissue homogenates provided a rapid diagnosis of bovine and bubaline tuberculosis.
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Rodriguez-Campos S, Smith NH, Boniotti MB, Aranaz A. Overview and phylogeny of Mycobacterium tuberculosis complex organisms: implications for diagnostics and legislation of bovine tuberculosis. Res Vet Sci 2014; 97 Suppl:S5-S19. [PMID: 24630673 DOI: 10.1016/j.rvsc.2014.02.009] [Citation(s) in RCA: 98] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 02/04/2014] [Accepted: 02/15/2014] [Indexed: 10/25/2022]
Abstract
Members of the Mycobacterium tuberculosis complex (MTBC) cause a serious disease with similar pathology, tuberculosis; in this review, bovine tuberculosis will be considered as disease caused by any member of the MTBC in bovids. Bovine tuberculosis is responsible for significant economic loss due to costly eradication programs and trade limitations and poses a threat to both endangered and protected species as well as to public health. We here give an overview on all members of the MTBC, focusing on their isolation from different animal hosts. We also review the recent advances made in elucidating the evolutionary and phylogenetic relationships of members of the MTBC. Because the nomenclature of the MTBC is controversial, its members have been considered species, subspecies or ecotypes, this review discusses the possible implications for diagnostics and the legal consequences of naming of new species.
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Affiliation(s)
- Sabrina Rodriguez-Campos
- Institute of Veterinary Bacteriology, Veterinary Faculty, University of Bern, Laenggassstrasse 122, 3012 Bern, Switzerland.
| | - Noel H Smith
- Animal Health and Veterinary Laboratories Agency, Weybridge, New Haw, Addlestone, Surrey KT15 3NB, UK
| | - Maria B Boniotti
- Centro Nazionale di Referenza per la Tubercolosi Bovina, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, via Bianchi 9, 25124 Brescia, Italy
| | - Alicia Aranaz
- Departamento de Sanidad Animal, Veterinary Faculty, Universidad Complutense de Madrid, Avda. Puerta de Hiero s/n, 28040 Madrid, Spain
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Santos ACB, Gaspareto RM, Viana BHJ, Mendes NH, Pandolfi JRC, Cardoso RF, Sato DN, David SCDM, Saad MHF, Rastogi N, Leite CQF. Mycobacterium tuberculosis population structure shift in a 5-year molecular epidemiology surveillance follow-up study in a low endemic agro-industrial setting in São Paulo, Brazil. Int J Mycobacteriol 2013; 2:156-65. [PMID: 26785984 DOI: 10.1016/j.ijmyco.2013.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 06/30/2013] [Indexed: 10/26/2022] Open
Abstract
Starting with 257 outpatients attending the specialized health service for tuberculosis (TB) between 2002 and 2006 in Araraquara, an agro-industrial area with low tuberculosis (TB) incidence in São Paulo state, Brazil, positive mycobacterial cultures were obtained in 130 cases, of which 121 were confirmed as Mycobacterium tuberculosis complex. This report assesses the genetic diversity observed on 69.42% (n=84) of the clinical isolates, for which both spoligotyping and 12-loci MIRU typing data were fully interpretable. In order to monitor changes in the population dynamics of circulating M. tuberculosis strains over time, spoligotypes were compared from this study (n=84) with an earlier study from 1998 to 2001 (n=70 strains); and these two datasets from low-incidence Araraquara area were also compared with a 2-year cohort in the nearby higher-incidence São Paulo city area from 2006 to 2008 (n=93). The results obtained showed that with 58.3% (49/84) of the strains, the Latin-American-Mediterranean (LAM) was the predominant lineage in the present follow-up study; major patterns being SIT42/LAM9 11.9% (10/84), and SIT20/LAM1 10.7% (9/84). As compared with the 1998-2001 period when 40% (28/70) of the isolates belonged to the ill-defined T family, it was replaced by LAM strains between 2002 and 2006 with a visible shift to a population structure characteristic of the metropolitan São Paulo city. Further typing of the follow-up isolates from 2002 to 2006 using 12 loci MIRUs in conjunction with conventional epidemiology did not link this population structure shift to an increase in ongoing transmission or drug-resistance. Instead, it is most probably linked to movements of the important migrant community of Araraquara to higher TB incidence metropolitan areas such as São Paulo city. This is of particular concern owing to the increment in the global burden of LAM strains and the recent association of certain LAM sublineages with multidrug- and extensively drug-resistant TB. These observations suggest the need for further molecular monitoring of the TB population structure and the evaluation of transmission trends amongst migrant workers and other risk groups, such as persons in homeless shelters, in correctional facilities, drug users, and those with HIV infection, etc.
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Affiliation(s)
- Adolfo Carlos Barreto Santos
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | | | | | - Natália Helena Mendes
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - José Rodrigo Cláudio Pandolfi
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | | | - Daisy Nakamura Sato
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | | | | | - Nalin Rastogi
- WHO Supranational TB Reference Laboratory, TB & Mycobacteria Unit, Institut Pasteur de la Guadeloupe, F97183 Abymes, Guadeloupe, France.
| | - Clarice Queico Fujimura Leite
- Department of Biological Sciences, School of Pharmaceutical Sciences, São Paulo State University - UNESP, Araraquara, SP, Brazil
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Chaoui I, Zozio T, Lahlou O, Sabouni R, Abid M, El Aouad R, Akrim M, Amzazi S, Rastogi N, El Mzibri M. Contribution of spoligotyping and MIRU-VNTRs to characterize prevalent Mycobacterium tuberculosis genotypes infecting tuberculosis patients in Morocco. INFECTION GENETICS AND EVOLUTION 2013; 21:463-71. [PMID: 23732366 DOI: 10.1016/j.meegid.2013.05.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/30/2013] [Accepted: 05/23/2013] [Indexed: 11/28/2022]
Abstract
In the present study, Mycobacterium tuberculosis complex (MTBC) clinical isolates from culture-positive TB patients in Morocco were studied by spoligotyping and 12-loci MIRU-VNTR typing methods to characterize prevalent genotypes (n = 219 isolates from 208 patients). Spoligotyping resulted in 39 unique patterns and 167 strains in 30 clusters (2-50 strains per cluster). Comparison with international database showed that 29 of 39 unique patterns matched existing shared spoligotype international types (SITs). Nine shared types containing 10 strains were newly created (SIT 2891 to SIT 2899); this led to the description of 69 SITs with 206 strains and two orphan patterns. The most prevalent spoligotype was SIT42 (LAM; n = 50 or 24% of isolates). The repartition of strains according to major MTBC clades was as follows LAM (46.1%)> Haarlem (26%) >ill-defined T superfamily (22.6%) and S clade (0.96%). On the other hand, Beijing, CAS (Central Asian) and EAI (East-African Indian) strains were absent in this setting. Subsequent 12-Loci MIRU typing resulted in a total of 25 SIT/MIT clusters (n = 66 isolates, 2-6 isolates per cluster), with a resulting recent transmission rate of 22.3%. The MIRU-VNTR patterns corresponded to 69 MITs for 138 strains and 46 orphan patterns. The most frequent patterns were MIT43 (n = 8), MIT9 (n = 7) and MIT42 (n = 7). HGDI analysis of the 12 MIRU loci showed that loci 10, 23 and 40 were highly discriminative in our setting. The results also underlined the usefulness of spoligotyping and MIRU-VNTR to detect mixed infections among certain of our TB patients. Globally, the results obtained showed that TB is almost exclusively transmitted in Morocco through evolutionary-modern MTBC lineages belonging to principal genetic groups 2/3 strains (Haarlem, LAM, T), with a high level of biodiversity seen by MIRU typing. This study provides with a 1st global snapshot of MTBC population structure in Morocco, and validates the potential use of spoligotyping in conjunction with minisatellites for future investigations in Morocco that should in future ideally include optimized 15- or 24-loci MIRU-VNTRs.
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Affiliation(s)
- Imane Chaoui
- Unité de Biologie et Recherches Médicales, Centre National de l'Energie, des Sciences et Techniques Nucléaires, Rabat, Morocco.
| | - Thierry Zozio
- WHO Supranational TB Reference Laboratory, Unité de la Tuberculose et des Mycobactéries, Institut Pasteur de Guadeloupe, F97183 Abymes, Guadeloupe, France
| | - Ouafae Lahlou
- Laboratoire de Référence de la Tuberculose, Institut National d'Hygiène, Rabat, Morocco
| | - Radia Sabouni
- Laboratoire de Référence de la Tuberculose, Institut National d'Hygiène, Rabat, Morocco
| | - Mohammed Abid
- Laboratoire de génétiques des mycobactéries, service de Recherches, Institut Pasteur, Tanger, Morocco
| | - Rajae El Aouad
- Laboratoire de Référence de la Tuberculose, Institut National d'Hygiène, Rabat, Morocco; Laboratoire de biologie moléculaire, Institut National d'Hygiène, Rabat, Morocco
| | - Mohammed Akrim
- Laboratoire de biologie moléculaire, Institut National d'Hygiène, Rabat, Morocco
| | - Said Amzazi
- Laboratoire de biochimie et Immunologie, Faculté des Sciences, Université Mohammed V, Rabat, Morocco
| | - Nalin Rastogi
- WHO Supranational TB Reference Laboratory, Unité de la Tuberculose et des Mycobactéries, Institut Pasteur de Guadeloupe, F97183 Abymes, Guadeloupe, France.
| | - Mohammed El Mzibri
- Unité de Biologie et Recherches Médicales, Centre National de l'Energie, des Sciences et Techniques Nucléaires, Rabat, Morocco
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