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Osei-Wusu S, Tetteh JKA, Musah AB, Ntiamoah DO, Arthur N, Adjei A, Arbues A, Ofori EA, Mensah KA, Galevo SEA, Frempong AF, Asare P, Asante-Poku A, Otchere ID, Kusi KA, Lenz TL, Gagneux S, Portevin D, Yeboah-Manu D. Macrophage susceptibility to infection by Ghanaian Mycobacterium tuberculosis complex lineages 4 and 5 varies with self-reported ethnicity. Front Cell Infect Microbiol 2023; 13:1163993. [PMID: 37645380 PMCID: PMC10461633 DOI: 10.3389/fcimb.2023.1163993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 07/24/2023] [Indexed: 08/31/2023] Open
Abstract
Background The epidemiology of Mycobacterium tuberculosis complex (MTBC) lineage 5 (L5) infections in Ghana revealed a significantly increased prevalence in Ewes compared to other self-reported ethnic groups. In that context, we sought to investigate the early phase of tuberculosis (TB) infection using ex vivo infection of macrophages derived from the blood of Ewe and Akan ethnic group volunteers with MTBC L4 and L5 strains. Methods The study participants consisted of 16 controls, among which self-reported Akan and Ewe ethnicity was equally represented, as well as 20 cured TB cases consisting of 11 Akans and 9 Ewes. Peripheral blood mononuclear cells were isolated from both healthy controls and cured TB cases. CD14+ monocytes were isolated and differentiated into monocyte-derived macrophages (MDMs) before infection with L4 or L5 endemic strains. The bacterial load was assessed after 2 hours (uptake) as well as 3 and 7 days post-infection. Results We observed a higher capacity of MDMs from Ewes to phagocytose L4 strains (p < 0.001), translating into a higher bacillary load on day 7 (p < 0.001) compared to L5, despite the higher replication rate of L5 in Ewe MDMs (fold change: 1.4 vs. 1.2, p = 0.03) among the controls. On the contrary, within macrophages from Akans, we observed a significantly higher phagocytic uptake of L5 (p < 0.001) compared to L4, also translating into a higher load on day 7 (p = 0.04). However, the replication rate of L4 in Akan MDMs was higher than that of L5 (fold change: L4 = 1.2, L4 = 1.1, p = 0.04). Although there was no significant difference in the uptake of L4 and L5 among cured TB cases, there was a higher bacterial load of both L4 (p = 0.02) and L5 (p = 0.02) on day 7 in Ewe MDMs. Conclusion Our results suggest that host ethnicity (driven by host genetic diversity), MTBC genetic diversity, and individual TB infection history are all acting together to modulate the outcome of macrophage infections by MTBC.
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Affiliation(s)
- Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Legon, Ghana
| | - John K. A. Tetteh
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | | | - Nelly Arthur
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Abraham Adjei
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Ainhoa Arbues
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ebenezer Addo Ofori
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Kwadwo Akyea Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | | | - Abena Frema Frempong
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Kwadwo Asamoah Kusi
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Tobias L. Lenz
- Research Group for Evolutionary Immunogenomics, Department of Biology, University of Hamburg, Hamburg, Germany
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Damien Portevin
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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Adu B, Bonney JH, Egyir B, Otchere ID, Asare P, Dennis FE, Bonney EY, Akuffo R, Asante IA, Obodai E, Kumordjie S, Appiah-Kubi J, Mohktar Q, Frempong HO, Asiedu-Bekoe F, Adusei-Poku MA, Aboagye JO, Agbodzi B, Yeboah C, Agbenyo SB, Uche PO, Attiku KO, Sekyere BT, Laryea D, Buabeng K, Lamptey H, Ghansah A, Yeboah-Manu D, Anang AK, Ampofo WK, Kyei GB, Odoom JK. SARS-CoV-2 Molecular Evolutionary Dynamics in the Greater Accra Region, Ghana. Emerg Infect Dis 2023; 29:862-865. [PMID: 36958011 PMCID: PMC10045712 DOI: 10.3201/eid2904.221410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
To assess dynamics of SARS-CoV-2 in Greater Accra Region, Ghana, we analyzed SARS-CoV-2 genomic sequences from persons in the community and returning from international travel. The Accra Metropolitan District was a major origin of virus spread to other districts and should be a primary focus for interventions against future infectious disease outbreaks.
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Affiliation(s)
| | | | - Beverly Egyir
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Francis E. Dennis
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Evelyn Yayra Bonney
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Richard Akuffo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Ivy A. Asante
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Evangeline Obodai
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Selassie Kumordjie
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Joyce Appiah-Kubi
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Quaneeta Mohktar
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Hilda Opoku Frempong
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Franklin Asiedu-Bekoe
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Mildred A. Adusei-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - James O. Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Bright Agbodzi
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Clara Yeboah
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Seyram B. Agbenyo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Peace O. Uche
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Keren O. Attiku
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Bernice Twenewaa Sekyere
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Dennis Laryea
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Kwame Buabeng
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Helena Lamptey
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Anita Ghansah
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - Abraham K. Anang
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - William K. Ampofo
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - George B. Kyei
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
| | - John K. Odoom
- Noguchi Memorial Institute for Medical Research, University of Ghana College of Health Sciences, Legon, Ghana (B. Adu, J.H.K. Bonney, B. Egyir, I.D. Otchere, P. Asare, F.E. Dennis, E.Y. Bonney, R. Akuffo, I.A. Asante, E. Obodai, S. Kumordjie, J. Appiah-Kubi, Q. Mohktar, H. Opoku Frempong, J.O. Aboagye, B. Agbodzi, C. Yeboah, S.B. Agbenyo, P.O. Uche, K.O. Attiku, B. Twenewaa Sekyere, D. Laryea, K. Buabeng, H. Lamptey, A. Ghansah, D. Yeboah-Manu, A.K. Anang, W.K. Ampofo, G.B. Kyei, J.K. Odoom)
- Ghana Health Service, Accra, Ghana (F. Asiedu-Bekoe)
- University of Ghana Medical School, Accra (M.A. Adusei-Poku)
- University of Ghana Medical Centre, Legon (G.B. Kyei)
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Otchere ID, Morgan PA, Asare P, Osei-Wusu S, Aboagye SY, Yirenkyi SO, Musah AB, Danso EK, Tetteh-Ocloo G, Afum T, Asante-Poku A, Laryea C, Poku YA, Bonsu F, Gagneux S, Yeboah-Manu D. Analysis of drug resistance among difficult-to-treat tuberculosis patients in Ghana identifies several pre-XDR TB cases. Front Microbiol 2023; 13:1069292. [PMID: 36713197 PMCID: PMC9878308 DOI: 10.3389/fmicb.2022.1069292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/28/2022] [Indexed: 01/14/2023] Open
Abstract
Background Resistance to tuberculosis (TB) drugs has become a major threat to global control efforts. Early case detection and drug susceptibility profiling of the infecting bacteria are essential for appropriate case management. The objective of this study was to determine the drug susceptibility profiles of difficult-to-treat (DTT) TB patients in Ghana. Methods Sputum samples obtained from DTT-TB cases from health facilities across Ghana were processed for rapid diagnosis and detection of drug resistance using the Genotype MTBDRplus and Genotype MTBDRsl.v2 from Hain Life science. Results A total of 298 (90%) out of 331 sputum samples processed gave interpretable bands out of which 175 (58.7%) were resistant to at least one drug (ANYr); 16.8% (50/298) were isoniazid-mono-resistant (INHr), 16.8% (50/298) were rifampicin-mono-resistant (RIFr), and 25.2% (75/298) were MDR. 24 (13.7%) of the ANYr were additionally resistant to at least one second line drug: 7.4% (2 RIFr, 1 INHr, and 10 MDR samples) resistant to only FQs and 2.3% (2 RIFr, 1 INHr, and 1 MDR samples) resistant to AMG drugs kanamycin (KAN), amikacin (AMK), capreomycin (CAP), and viomycin (VIO). Additionally, there were 4.0% (5 RIFr and 2 MDR samples) resistant to both FQs and AMGs. 81 (65.6%) out of 125 INH-resistant samples including INHr and MDR had katG-mutations (MT) whereas 15 (12%) had inhApro-MT. The remaining 28 (22.4%) had both katG and inhA MT. All the 19 FQ-resistant samples were gyrA mutants whereas the 10 AMGs were rrs (3), eis (3) as well as rrs, and eis co-mutants (4). Except for the seven pre-XDR samples, no sample had eis MT. Conclusion The detection of several pre-XDR TB cases in Ghana calls for intensified drug resistance surveillance and monitoring of TB patients to, respectively, ensure early diagnosis and treatment compliance.
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Affiliation(s)
- Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Portia Abena Morgan
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Samuel Yaw Aboagye
- Institute for Environment and Sanitation Studies, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana
| | | | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Emelia Konadu Danso
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Theophilus Afum
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - Yaw Adusi Poku
- National Tuberculosis Control Program, Ghana Health Service, Accra, Ghana
| | - Frank Bonsu
- National Tuberculosis Control Program, Ghana Health Service, Accra, Ghana
| | - Sebastien Gagneux
- Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
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Asante-Poku A, Morgan P, Osei-Wusu S, Aboagye SY, Asare P, Otchere ID, Adadey SM, Mnika K, Esoh K, Mawuta KH, Arthur N, Forson A, Mazandu GK, Wonkam A, Yeboah-Manu D. Genetic Analysis of TB Susceptibility Variants in Ghana Reveals Candidate Protective Loci in SORBS2 and SCL11A1 Genes. Front Genet 2022; 12:729737. [PMID: 35242163 PMCID: PMC8886735 DOI: 10.3389/fgene.2021.729737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 12/08/2021] [Indexed: 12/31/2022] Open
Abstract
Despite advancements made toward diagnostics, tuberculosis caused by Mycobacterium africanum (Maf) and Mycobacterium tuberculosis sensu stricto (Mtbss) remains a major public health issue. Human host factors are key players in tuberculosis (TB) outcomes and treatment. Research is required to probe the interplay between host and bacterial genomes. Here, we explored the association between selected human/host genomic variants and TB disease in Ghana. Paired host genotype datum and infecting bacterial isolate information were analyzed for associations using a multinomial logistic regression. Mycobacterium tuberculosis complex (MTBC) isolates were obtained from 191 TB patients and genotyped into different phylogenetic lineages by standard methods. Two hundred and thirty-five (235) nondisease participants were used as healthy controls. A selection of 29 SNPs from TB disease-associated genes with high frequency among African populations was assayed using a TaqMan® SNP Genotyping Assay and iPLEX Gold Sequenom Mass Genotyping Array. Using 26 high-quality SNPs across 326 case-control samples in an association analysis, we found a protective variant, rs955263, in the SORBS2 gene against both Maf and Mtb infections (PBH = 0.05; OR = 0.33; 95% CI = 0.32–0.34). A relatively uncommon variant, rs17235409 in the SLC11A1 gene was observed with an even stronger protective effect against Mtb infection (MAF = 0.06; PBH = 0.04; OR = 0.05; 95% CI = 0.04–0.05). These findings suggest SLC11A1 and SORBS2 as a potential protective gene of substantial interest for TB, which is an important pathogen in West Africa, and highlight the need for in-depth host-pathogen studies in West Africa.
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Affiliation(s)
- Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
- *Correspondence: Adwoa Asante-Poku,
| | - Portia Morgan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
| | - Samuel Mawuli Adadey
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Khuthala Mnika
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kevin Esoh
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kenneth Hayibor Mawuta
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Nelly Arthur
- Department of Chest Diseases, Korle-Bu Teaching Hospital Korle-Bu, Accra, Ghana
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital Korle-Bu, Accra, Ghana
| | - Gaston Kuzamunu Mazandu
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Ambroise Wonkam
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell, and Molecular Biology, University of Ghana, Accra, Ghana
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Amewu RK, Ade CF, Darko Otchere I, Morgan P, Yeboah-Manu D. Synthesis and Initial Testing of Novel Antimalarial and Antitubercular Isonicotinohydrazides. Results in Chemistry 2022. [DOI: 10.1016/j.rechem.2022.100287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Osei-Wusu S, Otchere ID, Morgan P, Musah AB, Siam IM, Asandem D, Afum T, Asare P, Asante-Poku A, Kusi KA, Gagneux S, Yeboah-Manu D. Genotypic and phenotypic diversity of Mycobacterium tuberculosis complex genotypes prevalent in West Africa. PLoS One 2021; 16:e0255433. [PMID: 34437584 PMCID: PMC8389432 DOI: 10.1371/journal.pone.0255433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/15/2021] [Indexed: 12/13/2022] Open
Abstract
Findings from previous comparative genomics studies of the Mycobacterium tuberculosis complex (MTBC) suggest genomic variation among the genotypes may have phenotypic implications. We investigated the diversity in the phenotypic profiles of the main prevalent MTBC genotypes in West Africa. Thirty-six whole genome sequenced drug susceptible MTBC isolates belonging to lineages 4, 5 and 6 were included in this study. The isolates were phenotypically characterized for urease activity, tween hydrolysis, Thiophen-2-Carboxylic Acid Hydrazide (TCH) susceptibility, nitric oxide production, and growth rate in both liquid (7H9) and solid media (7H11 and Löwenstein–Jensen (L-J)). Lineage 4 isolates showed the highest growth rate in both liquid (p = 0.0003) and on solid (L-J) media supplemented with glycerol (p<0.001) or pyruvate (p = 0.005). L6 isolates optimally utilized pyruvate compared to glycerol (p<0.001), whereas L5 isolates grew similarly on both media (p = 0.05). Lineage 4 isolates showed the lowest average time to positivity (TTP) (p = 0.01; Average TTP: L4 = 15days, L5 = 16.7days, L6 = 29.7days) and the highest logCFU/mL (p = 0.04; average logCFU/mL L4 = 5.9, L5 = 5.0, L6 = 4.4) on 7H11 supplemented with glycerol, but there was no significant difference in growth on 7H11 supplemented with pyruvate (p = 0.23). The highest release of nitrite was recorded for L5 isolates, followed by L4 and L6 isolates. However, the reverse was observed in the urease activity for the lineages. All isolates tested were resistant to TCH except for one L6 isolate. Comparative genomic analyses revealed several mutations that might explain the diverse phenotypic profiles of these isolates. Our findings showed significant phenotypic diversity among the MTBC lineages used for this study.
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Affiliation(s)
- Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Portia Morgan
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Abdul Basit Musah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Ishaque Mintah Siam
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Diana Asandem
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Theophilus Afum
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Kwadwo Asamoah Kusi
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
- * E-mail:
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Asare P, Asante-Poku A, Osei-Wusu S, Otchere ID, Yeboah-Manu D. The Relevance of Genomic Epidemiology for Control of Tuberculosis in West Africa. Front Public Health 2021; 9:706651. [PMID: 34368069 PMCID: PMC8342769 DOI: 10.3389/fpubh.2021.706651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/29/2021] [Indexed: 12/30/2022] Open
Abstract
Tuberculosis (TB), an airborne infectious disease caused by Mycobacterium tuberculosis complex (MTBC), remains a global health problem. West Africa has a unique epidemiology of TB that is characterized by medium- to high-prevalence. Moreover, the geographical restriction of M. africanum to the sub-region makes West Africa have an extra burden to deal with a two-in-one pathogen. The region is also burdened with low case detection, late reporting, poor treatment adherence leading to development of drug resistance and relapse. Sporadic studies conducted within the subregion report higher burden of drug resistant TB (DRTB) than previously thought. The need for more sensitive and robust tools for routine surveillance as well as to understand the mechanisms of DRTB and transmission dynamics for the design of effective control tools, cannot be overemphasized. The advancement in molecular biology tools including traditional fingerprinting and next generation sequencing (NGS) technologies offer reliable tools for genomic epidemiology. Genomic epidemiology provides in-depth insight of the nature of pathogens, circulating strains and their spread as well as prompt detection of the emergence of new strains. It also offers the opportunity to monitor treatment and evaluate interventions. Furthermore, genomic epidemiology can be used to understand potential emergence and spread of drug resistant strains and resistance mechanisms allowing the design of simple but rapid tools. In this review, we will describe the local epidemiology of MTBC, highlight past and current investigations toward understanding their biology and spread as well as discuss the relevance of genomic epidemiology studies to TB control in West Africa.
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Affiliation(s)
- Prince Asare
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Sanoussi CN, Coscolla M, Ofori-Anyinam B, Otchere ID, Antonio M, Niemann S, Parkhill J, Harris S, Yeboah-Manu D, Gagneux S, Rigouts L, Affolabi D, de Jong BC, Meehan CJ. Mycobacterium tuberculosis complex lineage 5 exhibits high levels of within-lineage genomic diversity and differing gene content compared to the type strain H37Rv. Microb Genom 2021; 7:000437. [PMID: 34241588 PMCID: PMC8477398 DOI: 10.1099/mgen.0.000437] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 04/22/2021] [Indexed: 12/27/2022] Open
Abstract
Pathogens of the Mycobacterium tuberculosis complex (MTBC) are considered to be monomorphic, with little gene content variation between strains. Nevertheless, several genotypic and phenotypic factors separate strains of the different MTBC lineages (L), especially L5 and L6 (traditionally termed Mycobacterium africanum) strains, from each other. However, this genome variability and gene content, especially of L5 strains, has not been fully explored and may be important for pathobiology and current approaches for genomic analysis of MTBC strains, including transmission studies. By comparing the genomes of 355 L5 clinical strains (including 3 complete genomes and 352 Illumina whole-genome sequenced isolates) to each other and to H37Rv, we identified multiple genes that were differentially present or absent between H37Rv and L5 strains. Additionally, considerable gene content variability was found across L5 strains, including a split in the L5.3 sub-lineage into L5.3.1 and L5.3.2. These gene content differences had a small knock-on effect on transmission cluster estimation, with clustering rates influenced by the selected reference genome, and with potential overestimation of recent transmission when using H37Rv as the reference genome. We conclude that full capture of the gene diversity, especially high-resolution outbreak analysis, requires a variation of the single H37Rv-centric reference genome mapping approach currently used in most whole-genome sequencing data analysis pipelines. Moreover, the high within-lineage gene content variability suggests that the pan-genome of M. tuberculosis is at least several kilobases larger than previously thought, implying that a concatenated or reference-free genome assembly (de novo) approach may be needed for particular questions.
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Affiliation(s)
- C. N'Dira Sanoussi
- Laboratoire de Référence des Mycobactéries, Cotonou, Benin
- Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Mireia Coscolla
- I2SysBio, University of Valencia-FISABIO Joint Unit, Valencia, Spain
| | - Boatema Ofori-Anyinam
- Food and Drugs Authority, Accra, Ghana
- Rutgers New Jersey Medical School, Rutgers University, New Jersey, USA
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Martin Antonio
- Medical Research Council Unit in The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Stefan Niemann
- German Center for Infection Research, partner site Borstel-Hamburg-Lübeck-Riems, Borstel, Germany
- Research Center Borstel, Molecular and Experimental Mycobacteriology, Borstel, Germany
| | - Julian Parkhill
- Wellcome Sanger Institute, Hinxton, UK
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | | | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Leen Rigouts
- Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
- Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Bouke C. de Jong
- Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Conor J. Meehan
- Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
- School of Chemistry and Biosciences, University of Bradford, Bradford, UK
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Ameke S, Asare P, Aboagye SY, Otchere ID, Osei-Wusu S, Yeboah-Manu D, Asante-Poku A. Molecular epidemiology of Mycobacterium tuberculosis complex in the Volta Region of Ghana. PLoS One 2021; 16:e0238898. [PMID: 33730036 PMCID: PMC7968653 DOI: 10.1371/journal.pone.0238898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/27/2021] [Indexed: 11/18/2022] Open
Abstract
CONTEXT Available molecular epidemiological data from recent studies suggest significant genetic variation between the different lineages of Mycobacterium tuberculosis complex (MTBC) and the MTBC lineages might have adapted to different human populations. AIM This study sought to determine the population structure of clinical MTBC isolates from the Volta Region of Ghana. METHODS The MTBC isolates obtained from collected sputum samples were identified by PCR detecting of IS6110 and genotyped using spoligotyping. Non-tuberculous mycobacterial isolates were characterized by amplification of the heat shock protein 65 (hsp65) gene and sequencing. The drug susceptibility profiles of the MTBCs determined using GenoType MTBDRplus. RESULTS One hundred and seventeen (117, 93.6%) out of 125 mycobacterial positive isolates were characterized as members of the MTBC of which M. tuberculosis sensu stricto (MTBss) and M. africanum (MAF) were respectively 94 (80.3%) and 23 (19.7%). In all, 39 distinct spoligotype patterns were obtained; 26 for MTBss and 13 for MAF lineages. Spoligotyping identified 89 (76%) Lineage 4, 16 (13.6%) Lineage 5, 7 (6.0%) Lineage 6, 3 (2.6%) Lineage 2, 1(0.9%) Lineage 3 and 1 (0.9%) Lineage 1. Among the Lineage 4 isolates, 62/89 (69.7%) belonged to Cameroon sub-lineage, 13 (14.7%) Ghana, 8 (9.0%) Haarlem, 2 (2.2%) LAM, 1 (1.1%) Uganda I, 1 (1.1%) X and the remaining two (2.2%) were orphan. Significant localization of MAF was found within the Ho municipality (n = 13, 29.5%) compared to the more cosmopolitan Ketu-South/Aflao (n = 3, 8.3%) (p-value = 0.017). Eight (8) non-tuberculous mycobacteria were characterized as M. abscessus (7) and M. fortuitum (1). CONCLUSION We confirmed the importance of M. africanum lineages as a cause of TB in the Volta region of Ghana.
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Affiliation(s)
- Selassie Ameke
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Prince Asare
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Samuel Yaw Aboagye
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- Bacteriology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
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10
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Asare P, Osei-Wusu S, Baddoo NA, Bedeley E, Otchere ID, Brites D, Loiseau C, Asante-Poku A, Prah DA, Borrell S, Reinhard M, Omari MA, Forson A, Koram KA, Gagneux S, Yeboah-Manu D. Genomic epidemiological analysis identifies high relapse among individuals with recurring tuberculosis and provides evidence of recent household-related transmission of tuberculosis in Ghana. Int J Infect Dis 2021; 106:13-22. [PMID: 33667696 PMCID: PMC8134059 DOI: 10.1016/j.ijid.2021.02.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 11/29/2022] Open
Abstract
Unresolved previous infection as major cause of recurring tuberculosis (TB) in Ghana. Genomic epidemiology identifies high relapse among recurrent TB cases in Ghana. 15-locus MIRU-VNTR typing is sufficient to predict the cause of TB recurrence. Evidence of recent household-related TB transmission in Ghana. Need for increased education by national TB control program.
Objective To retrospectively investigate the cause of recurring tuberculosis (rcTB) among participants with pulmonary TB recruited from a prospective population-based study conducted between July 2012 and December 2015. Methods Mycobacterium tuberculosis complex isolates obtained from rcTB cases were characterized by standard mycobacterial genotyping tools, whole-genome sequencing, and phylogenetic analysis carried out to assess strain relatedness. Results The majority (58.3%, 21/36) of study participants with rcTB episodes had TB recurrence within 12 months post treatment. TB strains with isoniazid (INH) resistance were found in 19.4% (7/36) of participants at the primary episode, of which 29% (2/7) were also rifampicin-resistant. On TB recurrence, an INH-resistant strain was found in a larger proportion of participants, 27.8% (10/36), of which 40% (4/10) were MDR-TB strains. rcTB was attributed to relapse (same strain) in 75.0% (27/36) of participants and 25.0% (9/36) to re-infection. Conclusion Our findings indicate that previous unresolved infectiondue to inadequate treatment, may be the major cause of rcTB.
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Affiliation(s)
- Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana; West African Centre for Cell Biology of Infectious Pathogens, UG, Ghana; Department of Biochemistry, Cell and Molecular Biology, UG, Ghana.
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | | | - Edmund Bedeley
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Daniela Brites
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Chloé Loiseau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Diana Ahu Prah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Miriam Reinhard
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Michael Amo Omari
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Kwadwo Ansah Koram
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana (UG), Ghana; West African Centre for Cell Biology of Infectious Pathogens, UG, Ghana
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11
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Coscolla M, Gagneux S, Menardo F, Loiseau C, Ruiz-Rodriguez P, Borrell S, Otchere ID, Asante-Poku A, Asare P, Sánchez-Busó L, Gehre F, Sanoussi CN, Antonio M, Affolabi D, Fyfe J, Beckert P, Niemann S, Alabi AS, Grobusch MP, Kobbe R, Parkhill J, Beisel C, Fenner L, Böttger EC, Meehan CJ, Harris SR, de Jong BC, Yeboah-Manu D, Brites D. Phylogenomics of Mycobacterium africanum reveals a new lineage and a complex evolutionary history. Microb Genom 2021; 7:000477. [PMID: 33555243 PMCID: PMC8208692 DOI: 10.1099/mgen.0.000477] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/29/2020] [Indexed: 01/08/2023] Open
Abstract
Human tuberculosis (TB) is caused by members of the Mycobacterium tuberculosis complex (MTBC). The MTBC comprises several human-adapted lineages known as M. tuberculosis sensu stricto, as well as two lineages (L5 and L6) traditionally referred to as Mycobacterium africanum. Strains of L5 and L6 are largely limited to West Africa for reasons unknown, and little is known of their genomic diversity, phylogeography and evolution. Here, we analysed the genomes of 350 L5 and 320 L6 strains, isolated from patients from 21 African countries, plus 5 related genomes that had not been classified into any of the known MTBC lineages. Our population genomic and phylogeographical analyses showed that the unclassified genomes belonged to a new group that we propose to name MTBC lineage 9 (L9). While the most likely ancestral distribution of L9 was predicted to be East Africa, the most likely ancestral distribution for both L5 and L6 was the Eastern part of West Africa. Moreover, we found important differences between L5 and L6 strains with respect to their phylogeographical substructure and genetic diversity. Finally, we could not confirm the previous association of drug-resistance markers with lineage and sublineages. Instead, our results indicate that the association of drug resistance with lineage is most likely driven by sample bias or geography. In conclusion, our study sheds new light onto the genomic diversity and evolutionary history of M. africanum, and highlights the need to consider the particularities of each MTBC lineage for understanding the ecology and epidemiology of TB in Africa and globally.
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Affiliation(s)
- Mireia Coscolla
- ISysBio, University of Valencia-FISABIO Joint Unit, Valencia, Spain
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Fabrizio Menardo
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Chloé Loiseau
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Leonor Sánchez-Busó
- Centre for Genomic Pathogen Surveillance, Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | - Florian Gehre
- Infectious Disease Epidemiology Department, Bernhard-Nocht-Institute for Tropical Medicine, Hamburg, Germany
- Health Department, East African Community (EAC), Arusha, Tanzania
| | - C. N’Dira Sanoussi
- Laboratoire de Référence des Mycobactéries, Ministry of Health, Cotonou, Bénin
- Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Martin Antonio
- London School of Hygiene and Tropical Medicine, London, UK
| | - Dissou Affolabi
- Laboratoire de Référence des Mycobactéries, Ministry of Health, Cotonou, Bénin
| | - Janet Fyfe
- Mycobacterium Reference Laboratory, Victoria Infectious Diseases Reference Laboratory, Peter Doherty Institute, Melbourne, Victoria, Australia
| | - Patrick Beckert
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- Partner Site Hamburg-Lübeck-Borstel-Riems, German Center for Infection Research, Borstel, Germany
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- Partner Site Hamburg-Lübeck-Borstel-Riems, German Center for Infection Research, Borstel, Germany
| | - Abraham S. Alabi
- Centre de Recherches Médicales en Lambaréné (Cermel), Lambaréné, Gabon
| | - Martin P. Grobusch
- Centre de Recherches Médicales en Lambaréné (Cermel), Lambaréné, Gabon
- Institut für Tropenmedizin, Deutsches Zentrum fuer Infektionsforschung, University of Tübingen, Tübingen, Germany
- Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Robin Kobbe
- First Department of Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Germany
| | - Julian Parkhill
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge, UK
| | - Christian Beisel
- Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland
| | - Lukas Fenner
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Erik C. Böttger
- Institute of Medical Microbiology, University of Zürich, Zürich, Switzerland
| | - Conor J. Meehan
- School of Chemistry and Biosciences, University of Bradford, Bradford, UK
| | - Simon R. Harris
- Wellcome Sanger Institute, Wellcome Genome Campus, Cambridge, UK
- Microbiotica Limited, Bioinnovation Centre, Wellcome Genome Campus, Cambridge, CB10 1DR, UK
| | - Bouke C. de Jong
- Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Daniela Brites
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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12
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Danso EK, Asare P, Otchere ID, Akyeh LM, Asante-Poku A, Aboagye SY, Osei-Wusu S, Opare D, Ntoumi F, Zumla A, Duodu S, Yeboah-Manu D. A molecular and epidemiological study of Vibrio cholerae isolates from cholera outbreaks in southern Ghana. PLoS One 2020; 15:e0236016. [PMID: 32649692 PMCID: PMC7351161 DOI: 10.1371/journal.pone.0236016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 06/27/2020] [Indexed: 11/18/2022] Open
Abstract
Cholera remains a major global public health threat and continuous emergence of new Vibrio cholerae strains is of major concern. We conducted a molecular epidemiological study to detect virulence markers and antimicrobial resistance patterns of V. cholerae isolates obtained from the 2012–2015 cholera outbreaks in Ghana. Archived clinical isolates obtained from the 2012, 2014 and 2015 cholera outbreaks in Ghana were revived by culture and subjected to microscopy, biochemical identification, serotyping, antibiotic susceptibility testing, molecular detection of distinct virulence factors and Multi-Locus Variable-Number of Tandem-Repeat Analysis (MLVA). Of 277 isolates analysed, 168 (60.6%) were confirmed to be V. cholerae and 109 (39.4%) isolates constituted other bacteria (Escherichia coli, Aeromonas sobria, Pseudomonas aeruginosa, Enterobacter cloacae and Enterococci faecalis). Serotyping the V. cholerae isolates identified 151 (89.9%) as Ogawa, 3 (1.8%) as Inaba and 14 (8.3%) as non-O1/O139 serogroup. The O1 serogroup isolates (154/168, 91.7%) carried the cholera toxin ctxB gene as detected by PCR. Additional virulence genes detected include zot, tcpA, ace, rtxC, toxR, rtxA, tcpP, hlyA and tagA. The most common and rare virulence factors detected among the isolates were rtxC (165 isolates) and tcpP (50 isolates) respectively. All isolates from 2014 and 2015 were multidrug resistant against the selected antibiotics. MLVA differentiated the isolates into 2 large unique clones A and B, with each predominating in a particular year. Spatial analysis showed clustering of most isolates at Ablekuma sub-district. Identification of several virulence genes among the two different genotypes of V. cholerae isolates and resistance to first- and second-line antibiotics, calls for scaleup of preventive strategies to reduce transmission, and strengthening of public health laboratories for rapid antimicrobial susceptibility testing to guide accurate treatment. Our findings support the current WHO licensed cholera vaccines which include both O1 Inaba and Ogawa serotypes.
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Affiliation(s)
- Emelia Konadu Danso
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana Legon, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Lorenzo Moses Akyeh
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- Institute for Environment and Sanitation Studies, University of Ghana, Legon, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - David Opare
- National Public Health and Reference Laboratory, Accra, Ghana
| | - Francine Ntoumi
- Université Marien NGouabi, Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo
- Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - Alimuddin Zumla
- Division of Infection and Immunity, University College London and NIHR Biomedical Research Centre, UCL Hospitals NHS Foundation Trust, London, England, United Kingdom
| | - Samuel Duodu
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana Legon, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana Legon, Legon, Accra, Ghana
- * E-mail:
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13
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Asare P, Otchere ID, Bedeley E, Brites D, Loiseau C, Baddoo NA, Asante-Poku A, Osei-Wusu S, Prah DA, Borrell S, Reinhard M, Forson A, Koram KA, Gagneux S, Yeboah-Manu D. Whole Genome Sequencing and Spatial Analysis Identifies Recent Tuberculosis Transmission Hotspots in Ghana. Front Med (Lausanne) 2020; 7:161. [PMID: 32509791 PMCID: PMC7248928 DOI: 10.3389/fmed.2020.00161] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/09/2020] [Indexed: 01/08/2023] Open
Abstract
Whole genome sequencing (WGS) is progressively being used to investigate the transmission dynamics of Mycobacterium tuberculosis complex (MTBC). We used WGS analysis to resolve traditional genotype clusters and explored the spatial distribution of confirmed recent transmission clusters. Bacterial genomes from a total of 452 MTBC isolates belonging to large traditional clusters from a population-based study spanning July 2012 and December 2015 were obtained through short read next-generation sequencing using the illumina HiSeq2500 platform. We performed clustering and spatial analysis using specified R packages and ArcGIS. Of the 452 traditional genotype clustered genomes, 314 (69.5%) were confirmed clusters with a median cluster size of 7.5 genomes and an interquartile range of 4–12. Recent tuberculosis (TB) transmission was estimated as 24.7%. We confirmed the wide spread of a Cameroon sub-lineage clone with a cluster size of 78 genomes predominantly from the Ablekuma sub-district of Accra metropolis. More importantly, we identified a recent transmission cluster associated with isoniazid resistance belonging to the Ghana sub-lineage of lineage 4. WGS was useful in detecting unsuspected outbreaks; hence, we recommend its use not only as a research tool but as a surveillance tool to aid in providing the necessary guided steps to track, monitor, and control TB.
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Affiliation(s)
- Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana.,West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana.,Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Edmund Bedeley
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Daniela Brites
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Chloé Loiseau
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Diana Ahu Prah
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sonia Borrell
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Miriam Reinhard
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Kwadwo Ansah Koram
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Accra, Ghana.,West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Accra, Ghana
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14
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Otchere ID, van Tonder AJ, Asante-Poku A, Sánchez-Busó L, Coscollá M, Osei-Wusu S, Asare P, Aboagye SY, Ekuban SA, Yahayah AI, Forson A, Baddoo A, Laryea C, Parkhill J, Harris SR, Gagneux S, Yeboah-Manu D. Molecular epidemiology and whole genome sequencing analysis of clinical Mycobacterium bovis from Ghana. PLoS One 2019; 14:e0209395. [PMID: 30830912 PMCID: PMC6398925 DOI: 10.1371/journal.pone.0209395] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 02/19/2019] [Indexed: 11/19/2022] Open
Abstract
Background Bovine tuberculosis (bTB) caused by Mycobacterium bovis is a re-emerging problem in both livestock and humans. The association of some M. bovis strains with hyper-virulence, MDR-TB and disseminated disease makes it imperative to understand the biology of the pathogen. Methods Mycobacterium bovis (15) among 1755 M. tuberculosis complex (MTBC) isolated between 2012 and 2014 were characterized and analyzed for associated patient demography and other risk factors. Five of the M. bovis isolates were whole-genome sequenced and comparatively analyzed against a global collection of published M. bovis genomes. Results Mycobacterium bovis was isolated from 3/560(0.5%) females and 12/1195(1.0%) males with pulmonary TB. The average age of M. bovis infected cases was 46.8 years (7-72years). TB patients from the Northern region of Ghana (1.9%;4/212) had a higher rate of infection with M. bovis (OR = 2.7,p = 0.0968) compared to those from the Greater Accra region (0.7%;11/1543). Among TB patients with available HIV status, the odds of isolating M. bovis from HIV patients (2/119) was 3.3 higher relative to non-HIV patients (4/774). Direct contact with livestock or their unpasteurized products was significantly associated with bTB (p<0.0001, OR = 124.4,95% CI = 30.1–508.3). Two (13.3%) of the M. bovis isolates were INH resistant due to the S315T mutation in katG whereas one (6.7%) was RIF resistant with Q432P and I1491S mutations in rpoB. M. bovis from Ghana resolved as mono-phyletic branch among mostly M. bovis from Africa irrespective of the host and were closest to the root of the global M. bovis phylogeny. M. bovis-specific amino acid mutations were detected among MTBC core genes such as mce1A, mmpL1, pks6, phoT, pstB, glgP and Rv2955c. Additional mutations P6T in chaA, G187E in mgtC, T35A in Rv1979c, S387A in narK1, L400F in fas and A563T in eccA1 were restricted to the 5 clinical M. bovis from Ghana. Conclusion Our data indicate potential zoonotic transmission of bTB in Ghana and hence calls for intensified public education on bTB, especially among risk groups.
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Affiliation(s)
- Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | - Mireia Coscollá
- Institute for Integrative Systems Biology (I2SysBio), University of Valencia-CSIC, Valencia, Spain
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | | | | | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Akosua Baddoo
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Clement Laryea
- Public Health Department, 37 Military Hospital, Accra, Ghana
| | - Julian Parkhill
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Simon R. Harris
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, United Kingdom
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
- * E-mail:
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Asante-Poku A, Asare P, Baddoo NA, Forson A, Klevor P, Otchere ID, Aboagye SY, Osei-Wusu S, Danso EK, Koram K, Gagneux S, Yeboah-Manu D. TB-diabetes co-morbidity in Ghana: The importance of Mycobacterium africanum infection. PLoS One 2019; 14:e0211822. [PMID: 30730937 PMCID: PMC6366779 DOI: 10.1371/journal.pone.0211822] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 01/21/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Diabetes Mellitus (DM) is a known risk factor for tuberculosis (TB) but little is known on TB-Diabetes Mellitus (TBDM) co-morbidity in Sub-Saharan Africa. METHODS Consecutive TB cases registered at a tertiary facility in Ghana were recruited from September 2012 to April 2016 and screened for DM using random blood glucose and glycated hemoglobin (HbA1c) level. TB patients were tested for other clinical parameters including HIV co-infection and TB lesion location. Mycobacterial isolates obtained from collected sputum samples were characterized by standard methods. Associations between TBDM patients' epidemiological as well as microbiological variables were assessed. RESULTS The prevalence of DM at time of diagnosis among 2990 enrolled TB cases was 9.4% (282/2990). TBDM cases were significantly associated with weight loss, poor appetite, night sweat and fatigue (p<0.001) and were more likely (p<0.001) to have lower lung cavitation 85.8% (242/282) compared to TB Non-Diabetic (TBNDM) patients 3.3% (90/2708). We observed 22.3% (63/282) treatment failures among TBDM patients compared to 3.8% (102/2708) among TBNDM patients (p<0.001). We found no significant difference in the TBDM burden attributed by M. tuberculosis sensu stricto (Mtbss) and Mycobacterium africanum (Maf) and (Mtbss; 176/1836, 9.6% and Maf; 53/468, 11.3%, p = 0.2612). We found that diabetic individuals were suggestively likely to present with TB caused by M. africanum Lineage 6 as opposed to Mtbss (odds ratio (OR) = 1.52; 95% confidence interval (CI): 0.92-2.42, p = 0.072). CONCLUSION Our findings confirms the importance of screening for diabetes during TB diagnosis and highlights the association between genetic diversity and diabetes. in Ghana.
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Affiliation(s)
- Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
- West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Accra, Ghana
| | | | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana
| | - Pius Klevor
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Sammy Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Emelia Konadu Danso
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Kwadwo Koram
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Accra, Ghana
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Sanoussi CN, de Jong BC, Odoun M, Arekpa K, Ali Ligali M, Bodi O, Harris S, Ofori-Anyinam B, Yeboah-Manu D, Otchere ID, Asante-Poku A, Anagonou S, Gagneux S, Coscolla M, Rigouts L, Affolabi D. Low sensitivity of the MPT64 identification test to detect lineage 5 of the Mycobacterium tuberculosis complex. J Med Microbiol 2018; 67:1718-1727. [PMID: 30388066 DOI: 10.1099/jmm.0.000846] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Differentiation of the Mycobacterium tuberculosis complex (MTBc) from non-tuberculous mycobacteria (NTM) is important for tuberculosis diagnosis and is a prerequisite for reliable phenotypic drug-resistance testing. We evaluated the performance of the rapid MPT64 antigen identification test for the detection of Mycobacterium africanum lineage 5 (MAF L5). METHODOLOGY Smear-positive tuberculosis patients' sputa were included prospectively. Culture was performed on Löwenstein-Jensen medium and, when positive, the MPT64 test and the classical para-nitro benzoic acid susceptibility and heat-labile catalase (PNB/catalase) identification tests were performed. The MPT64 test was repeated 14 days after an initially negative first testing. Direct spoligotyping was performed for MTBc lineage determination. RESULTS In total, 333 isolates were tested for all of the methods. Three hundred and twenty-two (96.7 %) were pure MTBc, by agreement between spoligotyping and PNB/catalase, and 11 were NTM or a mixture of MTBc/NTM. The MPT64 test conducted on day zero of culture-positivity correctly identified most of the pure MTBc isolates (93.2 %, 300/322), but it failed to detect 24 % of the L5 isolates (18/75) versus 2 % (4/202) of the L4 ones [OR=15.6 (5.3-45.8), P<0.0001], with improved sensitivity for L5 detection on repeat testing after 14 days. The L5-wide non-synonymous single-nucleotide polymorphism in the mpt64 gene may explain the poor performance of the MPT64 test for L5. CONCLUSION The MPT64 test has a lower sensitivity for detecting L5 isolates of the MTBc, and can be considered as a first-screening test that should be confirmed by another identification method when it produces negative results in countries with L5. Given the microbiological bias in both the isolation and identification of MAF lineages, diagnostics with high sensitivity for direct testing on clinical material are preferable.
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Affiliation(s)
- C N'Dira Sanoussi
- 2Laboratoire de Référence des Mycobactéries, Cotonou, Benin.,1Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bouke C de Jong
- 1Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - Mathieu Odoun
- 2Laboratoire de Référence des Mycobactéries, Cotonou, Benin
| | - Karamatou Arekpa
- 2Laboratoire de Référence des Mycobactéries, Cotonou, Benin.,3Génie de Biologie Humaine, Ecole Polytechnique d'Abomey-Calavi, Université d'Abomey-Calavi, Benin
| | | | - Ousman Bodi
- 2Laboratoire de Référence des Mycobactéries, Cotonou, Benin
| | - Simon Harris
- 4Wellcome Trust Sanger Institute, Hinxton CB10 1SA, UK
| | - Boatema Ofori-Anyinam
- 5Vaccine and Immunity Theme, Medical Research Council (MRC) Unit, Serrekunda, The Gambia
| | | | | | - Adwoa Asante-Poku
- 6Noguchi Memorial Institute for Medical Research, Legon, Accra, Ghana
| | | | | | | | - Leen Rigouts
- 1Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium.,9Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | - Dissou Affolabi
- 2Laboratoire de Référence des Mycobactéries, Cotonou, Benin
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Asare P, Asante-Poku A, Prah DA, Borrell S, Osei-Wusu S, Otchere ID, Forson A, Adjapong G, Koram KA, Gagneux S, Yeboah-Manu D. Reduced transmission of Mycobacterium africanum compared to Mycobacterium tuberculosis in urban West Africa. Int J Infect Dis 2018; 73:30-42. [PMID: 29879521 PMCID: PMC6069673 DOI: 10.1016/j.ijid.2018.05.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Understanding transmission dynamics is useful for tuberculosis (TB) control. A population-based molecular epidemiological study was conducted to determine TB transmission in Ghana. METHODS Mycobacterium tuberculosis complex (MTBC) isolates obtained from prospectively sampled pulmonary TB patients between July 2012 and December 2015 were characterized using spoligotyping and standard 15-locus mycobacterial interspersed repetitive unit variable number tandem repeat (MIRU-VNTR) typing for transmission studies. RESULTS Out of 2309 MTBC isolates, 1082 (46.9%) unique cases were identified, with 1227 (53.1%) isolates belonging to one of 276 clusters. The recent TB transmission rate was estimated to be 41.2%. Whereas TB strains of lineage 4 belonging to M. tuberculosis showed a high recent transmission rate (44.9%), reduced recent transmission rates were found for lineages of Mycobacterium africanum (lineage 5, 31.8%; lineage 6, 24.7%). CONCLUSIONS The study findings indicate high recent TB transmission, suggesting the occurrence of unsuspected outbreaks in Ghana. The observed reduced transmission rate of M. africanum suggests other factor(s) (host/environmental) may be responsible for its continuous presence in West Africa.
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Affiliation(s)
- Prince Asare
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana; West African Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana; Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | - Diana Ahu Prah
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | | | | | - Kwadwo Ansah Koram
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Legon, Ghana.
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Otchere ID, Coscollá M, Sánchez-Busó L, Asante-Poku A, Brites D, Loiseau C, Meehan C, Osei-Wusu S, Forson A, Laryea C, Yahayah AI, Baddoo A, Ansa GA, Aboagye SY, Asare P, Borrell S, Gehre F, Beckert P, Kohl TA, N'dira S, Beisel C, Antonio M, Niemann S, de Jong BC, Parkhill J, Harris SR, Gagneux S, Yeboah-Manu D. Comparative genomics of Mycobacterium africanum Lineage 5 and Lineage 6 from Ghana suggests distinct ecological niches. Sci Rep 2018; 8:11269. [PMID: 30050166 PMCID: PMC6062541 DOI: 10.1038/s41598-018-29620-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 07/16/2018] [Indexed: 11/09/2022] Open
Abstract
Mycobacterium africanum (Maf) causes a substantial proportion of human tuberculosis in some countries of West Africa, but little is known on this pathogen. We compared the genomes of 253 Maf clinical isolates from Ghana, including N = 175 Lineage 5 (L5) and N = 78 Lineage 6 (L6). We found that the genomic diversity of L6 was higher than in L5 despite the smaller sample size. Regulatory proteins appeared to evolve neutrally in L5 but under purifying selection in L6. Even though over 90% of the human T cell epitopes were conserved in both lineages, L6 showed a higher ratio of non-synonymous to synonymous single nucleotide variation in these epitopes overall compared to L5. Of the 10% human T cell epitopes that were variable, most carried mutations that were lineage-specific. Our findings indicate that Maf L5 and L6 differ in some of their population genomic characteristics, possibly reflecting different selection pressures linked to distinct ecological niches.
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Affiliation(s)
- Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Legon, Accra, Ghana
| | - Mireia Coscollá
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Leonor Sánchez-Busó
- Wellcome Trust Sanger Institute, University of Cambridge, Hinxton, United Kingdom
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Daniela Brites
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Chloe Loiseau
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Conor Meehan
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Audrey Forson
- Chest Clinic, Korle-Bu Teaching Hospital, Accra, Ghana
| | | | | | - Akosua Baddoo
- Chest Clinic, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Gloria Akosua Ansa
- Public Health Department, University of Ghana Hospital, Legon, Accra, Ghana
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Sonia Borrell
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Florian Gehre
- Institute of Tropical Medicine, Antwerp, Belgium
- Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Patrick Beckert
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner Site Hamburg-Borstel-Lübeck, Lübeck, Germany
| | - Thomas A Kohl
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner Site Hamburg-Borstel-Lübeck, Lübeck, Germany
| | - Sanoussi N'dira
- National Reference Laboratory for Mycobacteria, Cotonou, Benin
| | - Christian Beisel
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - Martin Antonio
- Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Banjul, The Gambia
- Division of Microbiology & Immunity, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Borstel, Germany
- German Center for Infection Research, Partner Site Hamburg-Borstel-Lübeck, Lübeck, Germany
| | - Bouke C de Jong
- Institute of Tropical Medicine, Antwerp, Belgium
- Medical Research Council Unit The Gambia at The London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Julian Parkhill
- Wellcome Trust Sanger Institute, University of Cambridge, Hinxton, United Kingdom
| | - Simon R Harris
- Wellcome Trust Sanger Institute, University of Cambridge, Hinxton, United Kingdom
| | - Sebastien Gagneux
- Swiss Tropical and Public Health Institute, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
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Otchere ID, Asante-Poku A, Osei-Wusu S, Aboagye SY, Yeboah-Manu D. Isolation and characterization of nontuberculous mycobacteria from patients with pulmonary tuberculosis in Ghana. Int J Mycobacteriol 2018; 6:70-75. [PMID: 28317808 DOI: 10.4103/2212-5531.201895] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE/BACKGROUND Nontuberculous mycobacterial (NTM) species are assuming public health importance in pulmonary diseases; they are increasingly being isolated, and importantly, most NTMs do not respond to routine tuberculosis (TB) drugs. This study aimed to identify NTMs isolated from pulmonary TB cases and also determine their susceptibility to streptomycin (STR), isoniazid (INH), and rifampicin (RIF). METHODS A total of 1755 mycobacterial isolates, obtained between August 2012 and July 2014, from 2036 smear-positive pulmonary cases were identified using polymerase chain reaction amplification of IS6110, and hsp65 gene sequencing analysis. Drug susceptibility testing (DST) was then performed for the identified NTMs against STR, INH, and RIF using microplate Alamar blue assay. The results were analyzed against patients' biodata for statistical associations. RESULTS Of the 1755 analyzed isolates, we identified 43 (2.5%) NTMs, which included 18 (41.9%) Mycobacterium intracellulare, 13 (30.2%) Mycobacterium avium subs. paratuberculosis, 5 (11.3%) Mycobacterium abscessus, 3 (7.0%) each of Mycobacterium mucogenicum and Mycobacterium colombiense, and 1 (2.3%) Mycobacterium simiae. Patients infected with NTMs (52.0%) were more likely to be human immunodeficiency virus-positive (P = 0.001, odds ratio = 6.6, 95% confidence interval = 2.7-16.2) than those infected with M. tuberculosis complex (5.8%). All the 43 (100%) NTMs were resistant to INH, whereas 32 (74%) and 19 (44%) were resistant to RIF and STR, respectively. Furthermore, 16 (37.2%) NTMs were resistant to all three drugs, 20 were resistant to INH and RIF, and 3 were resistant to STR and INH. All the M. abscessus isolates were resistant to all the three drugs, whereas all the M. avium isolates were resistant to INH and RIF, but only three were resistant to STR. Among the M. intracellulare isolates, 8, 18, and 15 isolates were resistant to STR, INH, and RIF, respectively. CONCLUSION The observed high-resistance level to INH and RIF supports the need for rapid species identification and DST of nonresponding TB cases before retreatment.
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Affiliation(s)
- Isaac Darko Otchere
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of , Accra, Ghana
| | - Adwoa Asante-Poku
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of , Accra, Ghana
| | - Stephen Osei-Wusu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of , Accra, Ghana
| | - Samuel Yaw Aboagye
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of , Accra, Ghana
| | - Dorothy Yeboah-Manu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of , Accra, Ghana
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Osei-Wusu S, Amo Omari M, Asante-Poku A, Darko Otchere I, Asare P, Forson A, Otu J, Antonio M, Yeboah-Manu D. Second-line anti-tuberculosis drug resistance testing in Ghana identifies the first extensively drug-resistant tuberculosis case. Infect Drug Resist 2018; 11:239-246. [PMID: 29503573 PMCID: PMC5825993 DOI: 10.2147/idr.s152720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Drug resistance surveillance is crucial for tuberculosis (TB) control. Therefore, our goal was to determine the prevalence of second-line anti-TB drug resistance among diverse primary drug-resistant Mycobacterium tuberculosis complex (MTBC) isolates in Ghana. MATERIALS AND METHODS One hundred and seventeen MTBC isolates with varying first-line drug resistance were analyzed. Additional resistance to second-line anti-TB drugs (streptomycin [STR], amikacin [AMK] and moxifloxacin [MOX]) was profiled using the Etest and GenoType MTBDRsl version 2.0. Genes associated with resistance to AMK and MOX (gyrA, gyrB, eis, rrs, tap, whiB7 and tlyA) were then analyzed for mutation. RESULTS Thirty-seven (31.9%) isolates had minimum inhibitory concentration (MIC) values ≥2 µg/mL against STR while 12 (10.3%) isolates had MIC values ≥1 µg/mL for AMK. Only one multidrug-resistant (MDR) isolate (Isolate ID: TB/Nm 919) had an MIC value of ≥0.125 µg/mL for MOX (MIC = 3 µg/mL). This isolate also had the highest MIC value for AMK (MIC = 16 µg/mL) and was confirmed as resistant to AMK and MOX by the line probe assay GenoType MTBDRsl version 2.0. Mutations associated with the resistance were: gyrA (G88C) and rrs (A514C and A1401G). CONCLUSION Our findings suggest the need to include routine second-line anti-TB drug susceptibility testing of MDR/rifampicin-resistant isolates in our diagnostic algorithm.
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Affiliation(s)
- Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
- West Africa Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana
| | - Michael Amo Omari
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Jacob Otu
- Medical Research Council Unit, Fajara, The Gambia
| | | | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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Aboagye SY, Asare P, Otchere ID, Koka E, Mensah GE, Yirenya-Tawiah D, Yeboah-Manu D. Environmental and Behavioral Drivers of Buruli Ulcer Disease in Selected Communities Along the Densu River Basin of Ghana: A Case-Control Study. Am J Trop Med Hyg 2017; 96:1076-1083. [PMID: 28500810 PMCID: PMC5417198 DOI: 10.4269/ajtmh.16-0749] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The exact route of transmission of Mycobacterium ulcerans (MU) (causative agent of Buruli ulcer [BU]), risk factors, and reservoir hosts are not clearly known, although it has been identified as an environmental pathogen. This study assessed potential environmental and behavioral risk factors that influence BU infections. We conducted a case-control study where cases were matched by their demographic characteristics and place of residence. A structured questionnaire was administered to solicit information on the environmental and behavioral factors of participants that may expose them to infection. A total of 176 cases and 176 controls were enrolled into the study. Multivariate conditional logistic regression analysis identified farming in swampy areas (odds ratio [OR] = 4.10, 95% confidence interval [CI] = 3.82–7.18), farming while wearing short clothing (OR = 1,734.1, 95% CI = 68.1–44,120.9), insect bite (OR = 988.3, 95% CI = 31.4–31,115.6), and application of leaves on wounds (OR = 6.23, 95% CI = 4.74–18.11) as potential risk factors. Farming in long clothing (OR = 0.000, 95% CI = 0.00–0.14), washing wound with water and soap (OR = 0.37, 95% CI = 0.29–0.98), and application of adhesive bandage on wounds (OR = 0.31, 95% CI = 0.15–0.82) were found to be protective against BU infection. In the absence of the exact MU transmission mechanisms, education of public in BU-endemic zones on the use of protective clothing during farming activities to limit exposure of the skin and proper wound care management would be essential in the fight against BU.
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Affiliation(s)
- Samuel Yaw Aboagye
- Institute of Environmental and Sanitation Studies, University of Ghana, Accra, Ghana.,Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Asare
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Eric Koka
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - George Ekow Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Dzidzo Yirenya-Tawiah
- Institute of Environmental and Sanitation Studies, University of Ghana, Accra, Ghana
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
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Aboagye SY, Ampah KA, Ross A, Asare P, Otchere ID, Fyfe J, Yeboah-Manu D. Seasonal Pattern of Mycobacterium ulcerans, the Causative Agent of Buruli Ulcer, in the Environment in Ghana. Microb Ecol 2017; 74:350-361. [PMID: 28238016 PMCID: PMC5496970 DOI: 10.1007/s00248-017-0946-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 01/31/2017] [Indexed: 06/06/2023]
Abstract
This study aimed to contribute to the understanding of Mycobacterium ulcerans (MU) ecology by analysing both clinical and environmental samples collected from ten communities along two major river basins (Offin and Densu) associated with Buruli ulcer (BU) at different seasons. We collected clinical samples from presumptive BU cases and environmental samples from ten communities. Following DNA extraction, clinical samples were confirmed by IS2404 PCR and environmental samples were confirmed by targeting MU-specific genes, IS2404, IS2606 and the ketoreductase (KR) using real-time PCR. Environmental samples were first analysed for IS2404; after which, IS2404-positive samples were multiplexed for the IS2606 and KR gene. Our findings indicate an overall decline in BU incidence along both river basins, although incidence at Densu outweighs that of Offin. Overall, 1600 environmental samples were screened along Densu (434, 27 %) and Offin (1166, 73 %) and MU was detected in 139 (9 %) of the combined samples. The positivity of MU along the Densu River basin was 89/434 (20.5 %), whilst that of the Offin River basin was 50/1166 (4.3 %). The DNA was detected mainly in snails (5/6, 83 %), moss (8/40, 20 %), soil (55/586, 9 %) and vegetation (55/675, 8 %). The proportion of MU positive samples recorded was higher during the months with higher rainfall levels (126/1175, 11 %) than during the dry season months (13/425, 3 %). This study indicates for the first time that there is a seasonal pattern in the presence of MU in the environment, which may be related to recent rainfall or water in the soil.
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Affiliation(s)
- Samuel Yaw Aboagye
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana
- Institute of Environmental and Sanitation Studies, University of Ghana, Accra, Ghana
| | - Kobina Assan Ampah
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Amanda Ross
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Prince Asare
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana
| | - Isaac Darko Otchere
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana
| | - Janet Fyfe
- Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia
| | - Dorothy Yeboah-Manu
- Bacteriology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana.
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Zumla A, Otchere ID, Mensah GI, Asante-Poku A, Gehre F, Maeurer M, Bates M, Mwaba P, Ntoumi F, Yeboah-Manu D. Learning from epidemiological, clinical, and immunological studies on Mycobacterium africanum for improving current understanding of host–pathogen interactions, and for the development and evaluation of diagnostics, host-directed therapies, and vaccines for tuberculosis. Int J Infect Dis 2017; 56:126-129. [DOI: 10.1016/j.ijid.2016.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/01/2016] [Accepted: 12/05/2016] [Indexed: 11/25/2022] Open
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Sakyi SA, Aboagye SY, Otchere ID, Liao AM, Caltagirone TG, Yeboah-Manu D. RNA Aptamer That Specifically Binds to Mycolactone and Serves as a Diagnostic Tool for Diagnosis of Buruli Ulcer. PLoS Negl Trop Dis 2016; 10:e0004950. [PMID: 27776120 PMCID: PMC5077154 DOI: 10.1371/journal.pntd.0004950] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 08/03/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Buruli ulcer (BU) is a subcutaneous skin disease listed among the neglected tropical diseases by the World Health Organization (WHO). Early case detection and management is very important to reduce morbidity and the accompanied characteristic disfiguring nature of BU. Since diagnosis based on clinical evidence can lead to misdiagnosis, microbiological confirmation is essential to reduce abuse of drugs; since the anti-mycobacterial drugs are also used for TB treatment. The current WHO gold standard PCR method is expensive, requires infrastructure and expertise are usually not available at the peripheral centers where BU cases are managed. Thus one of the main research agendas is to develop methods that can be applied at the point of care. In this study we selected aptamers, which are emerging novel class of detection molecules, for detecting mycolactone, the first to be conducted in a BUD endemic country. METHODS Aptamers that bind to mycolactone were isolated by the SELEX process. To measure their affinity and specificity to mycolactone, the selected aptamers were screened by means of isothermal titration calorimetry (ITC) and an enzyme-linked oligonucleotide assay (ELONA). Selected aptamers were assessed by ELONA using swab samples from forty-one suspected BU patients with IS2404 PCR and culture as standard methods. ROC analysis was used to evaluate their accuracy and cutoff-points. RESULTS Five out of the nine selected aptamers bound significantly (p< 0.05) to mycolactone, of these, three were able to distinguish between mycolactone producing mycobacteria, M. marinum (CC240299, Israel) and other bacteria whilst two others also bounded significantly to Mycobacterium smegmatis. Their dissociation constants were in the micro-molar range. At 95% confidence interval, the ROC curve analysis among the aptamers at OD450 ranged from 0.5-0.7. Using this cut-off for the ELONA assay, the aptamers had 100% specificity and sensitivity between 0.0% and 50.0%. The most promising aptamer, Apt-3683 showed a discernible cleavage difference relative to the non-specific autocatalysis over a 3-minute time course. CONCLUSION This preliminary proof-of-concept indicates that diagnosis of BUD with RNA aptamers is feasible and can be used as point of care upon incorporation into a diagnostic platform.
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Affiliation(s)
- Samuel A. Sakyi
- Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- * E-mail:
| | - Samuel Yaw Aboagye
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Isaac Darko Otchere
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Albert M. Liao
- Aptagen LLC, Jacobus, Pennsylvania, United States of America
| | | | - Dorothy Yeboah-Manu
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
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Asante-Poku A, Otchere ID, Osei-Wusu S, Sarpong E, Baddoo A, Forson A, Laryea C, Borrell S, Bonsu F, Hattendorf J, Ahorlu C, Koram KA, Gagneux S, Yeboah-Manu D. Molecular epidemiology of Mycobacterium africanum in Ghana. BMC Infect Dis 2016; 16:385. [PMID: 27506391 PMCID: PMC4977717 DOI: 10.1186/s12879-016-1725-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 07/20/2016] [Indexed: 11/30/2022] Open
Abstract
Background Mycobacterium africanum comprises two phylogenetic lineages within the M. tuberculosis complex (MTBC) and is an important cause of human tuberculosis (TB) in West Africa. The reasons for this geographic restriction of M. africanum remain unclear. Here, we performed a prospective study to explore associations between the characteristics of TB patients and the MTBC lineages circulating in Ghana. Method We genotyped 1,211 MTBC isolates recovered from pulmonary TB patients recruited between 2012 and 2014 using single nucleotide polymorphism typing and spoligotyping. Associations between patient and pathogen variables were assessed using univariate and multivariate logistic regression. Results Of the 1,211 MTBC isolates analysed, 71.9 % (871) belonged to Lineage 4; 12.6 % (152) to Lineage 5 (also known as M. africanum West-Africa 1), 9.2 % (112) to Lineage 6 (also known as M. africanum West-Africa 2) and 0.6 % (7) to Mycobacterium bovis. Univariate analysis revealed that Lineage 6 strains were less likely to be isoniazid resistant compared to other strains (odds ratio = 0.25, 95 % confidence interval (CI): 0.05–0.77, P < 0.01). Multivariate analysis showed that Lineage 5 was significantly more common in patients from the Ewe ethnic group (adjusted odds ratio (adjOR): 2.79; 95 % CI: 1.47–5.29, P < 0.001) and Lineage 6 more likely to be found among HIV-co-infected TB patients (adjOR = 2.2; 95 % confidence interval (CI: 1.32–3.7, P < 0.001). Conclusion Our findings confirm the importance of M. africanum in Ghana and highlight the need to differentiate between Lineage 5 and Lineage 6, as these lineages differ in associated patient variables. Electronic supplementary material The online version of this article (doi:10.1186/s12879-016-1725-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Stephen Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Esther Sarpong
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Akosua Baddoo
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-bu, Accra, Ghana
| | - Audrey Forson
- Department of Chest Diseases, Korle-Bu Teaching Hospital, Korle-bu, Accra, Ghana
| | | | - Sonia Borrell
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Frank Bonsu
- National Tuberculosis Programme, Ghana health Service, Accra, Ghana
| | - Jan Hattendorf
- University of Basel, Basel, Switzerland.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Collins Ahorlu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Kwadwo A Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.
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Otchere ID, Asante-Poku A, Osei-Wusu S, Baddoo A, Sarpong E, Ganiyu AH, Aboagye SY, Forson A, Bonsu F, Yahayah AI, Koram K, Gagneux S, Yeboah-Manu D. Detection and characterization of drug-resistant conferring genes in Mycobacterium tuberculosis complex strains: A prospective study in two distant regions of Ghana. Tuberculosis (Edinb) 2016; 99:147-154. [PMID: 27450017 PMCID: PMC4978697 DOI: 10.1016/j.tube.2016.05.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 05/26/2016] [Accepted: 05/28/2016] [Indexed: 11/29/2022]
Abstract
We spoligotyped and screened 1490 clinical Mycobacterium tuberculosis complex strains from Northern and Greater Accra regions of Ghana against INH and RIF using the microplate alamar blue phenotypic assay. Specific drug resistance associated genetic elements of drug resistant strains were analyzed for mutations. A total of 111 (7.5%), 10 (0.7%) and 40 (2.6%) were mono-resistant to INH, RIF, and MDR, respectively. We found the Ghana spoligotype to be associated with drug resistance (INH: 22.1%; p = 0.0000, RIF: 6.2%; p = 0.0103, MDR: 4.6%; p = 0.0240) as compared to the Cameroon spoligotype (INH: 6.7%, RIF: 2.4%, MDR: 1.6%). The propensity for an isolate to harbour katG S315T mutation was higher in M. tuberculosis (75.8%) than Mycobacterium africanum (51.7%) (p = 0.0000) whereas the opposite was true for inhApro mutations; MAF (48.3%) compared to MTBSS (26.7%) (p = 0.0419). We identified possible novel compensatory INH resistance mutations in inhA (G204D) and ahpCpro (-88G/A and -142G/A) and a novel ndh mutation K32R. We detected two possible rpoC mutations (G332R and V483G), which occurred independently with rpoB S450L, respectively. The study provides the first evidence that associate the Ghana spoligotype with DR-TB and calls for further genome analyses for proper classification of this spoligotype and to explore for fitness implications and mechanisms underlying this observation.
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Affiliation(s)
- I D Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana; Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - A Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - S Osei-Wusu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - A Baddoo
- Chest Clinic, Korle-BU Teaching Hospital, Accra, Ghana
| | - E Sarpong
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - A H Ganiyu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - S Y Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - A Forson
- Chest Clinic, Korle-BU Teaching Hospital, Accra, Ghana
| | - F Bonsu
- Ghana Health Service, Ministry of Health, Accra, Ghana
| | - A I Yahayah
- Chest Department, Tamale Teaching Hospital, Tamale, Ghana
| | - K Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - S Gagneux
- Swiss TPH, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - D Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
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Asante-Poku A, Otchere ID, Danso E, Mensah DD, Bonsu F, Gagneux S, Yeboah-Manu D. Evaluation of GenoType MTBDRplus for the rapid detection of drug-resistant tuberculosis in Ghana. Int J Tuberc Lung Dis 2016; 19:954-959. [PMID: 26162362 DOI: 10.5588/ijtld.14.0864] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rapid but simple diagnostic tools for the detection of drug-resistant (DR) tuberculosis (TB) have been acknowledged as being important for its effective management and control. OBJECTIVE To establish a molecular line-probe assay (GenoType MTBDRplus) for detecting DR-TB in Ghana. METHOD We first screened 113 Mycobacterium tuberculosis isolates using the indirect proportion method and MTBDRplus. The rpoB and katG genes and the promoter regions of oxyR-ahpC and inhA were sequenced to identify mutations in isolates found to be resistant on phenotypic drug susceptibility testing and/or MTBDRplus. We then analysed an additional 412 isolates using only MTBDRplus. RESULTS Respectively 43 (8.2%) and 8 (1.5%) isolates were resistant to isoniazid (INH) and rifampicin (RMP), while 8 (1.5%) were multidrug-resistant. In resistant isolates, mutations in codon 450 of rpoB and codon 315 of katG, conferring resistance to respectively RMP and INH, dominated. We found two RMP-resistant isolates with a S450L substitution, each harbouring an additional mutation at S388L and Q409R. Using phenotypic testing as gold standard, the MTBDRplus assay showed a sensitivity and specificity in the detection of RMP and INH resistance and multidrug resistance of respectively 100% and 100%, 83.3% and 100%, and 100% and 100%. CONCLUSION The high sensitivity of MTBDRplus makes it a valuable addition to the conventional TB diagnostic algorithm in Ghana.
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Affiliation(s)
- Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana.,Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Isaac Darko Otchere
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Emelia Danso
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - David Delali Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Frank Bonsu
- National Tuberculosis Control Program, Ghana Health Service
| | - Sebastien Gagneux
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
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