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Population structure of drug-resistant Mycobacterium tuberculosis in Central Asia
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Biochemistry and Microbiology. Res Ctr Borstel, Mol & Expt Mycobacteriol, Pk Allee 1, D-23845 Borstel, Germany;Sci Life Lab, Clin Genom, Tomtebodavagen 23 A, S-17165 Solna, Sweden;KTH Royal Inst Technol, Sch Engn Sci Chem Biotechnol & Hlth, Div Gene Technol, Stockholm, Sweden;Sci Life Lab, Tomtebodavagen 23 A, S-17165 Solna, Sweden.
IML Red GmbH, WHO Supranatl Reference Lab TB, Inst Microbiol & Lab Med, Robert Koch Allee 2, D-82131 Gauting, Germany.
Natl TB Inst, 90a Ahuunbaen St, Bishkek 720075, Kyrgyzstan.
Natl Reference Lab TB, 90a Ahuunbaen St, Bishkek 720075, Kyrgyzstan.
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2019 (English)In: BMC Infectious Diseases, ISSN 1471-2334, E-ISSN 1471-2334, Vol. 19, article id 908Article in journal (Refereed) Published
Abstract [en]

Background: Drug-resistant tuberculosis (TB) is a major public health concern threathing the success of TB control efforts, and this is particularily problematic in Central Asia. Here, we present the first analysis of the population structure of Mycobacterium tuberculosis complex isolates in the Central Asian republics Uzbekistan, Tajikistan, and Kyrgyzstan.

Methods: The study set consisted of 607 isolates with 235 from Uzbekistan, 206 from Tajikistan, and 166 from Kyrgyzstan. 24-loci MIRU-VNTR (Mycobacterial Interspersed Repetitive Units - Variable Number of Tandem Repeats) typing and spoligotyping were combined for genotyping. In addition, phenotypic drug suceptibility was performed.

Results: The population structure mainly comprises strains of the Beijing lineage (411/607). 349 of the 411 Beijing isolates formed clusters, compared to only 33 of the 196 isolates from other clades. Beijing 94-32 (n = 145) and 100-32 (n = 70) formed the largest clusters. Beijing isolates were more frequently multidrug-resistant, pre-extensively resistant (pre-XDR)- or XDR-TB than other genotypes.

Conclusions: Beijing clusters 94-32 and 100-32 are the dominant MTB genotypes in Central Asia. The relative size of 100-32 compared to previous studies in Kazakhstan and its unequal geographic distribution support the hypothesis of its more recent emergence in Central Asia. The data also demonstrate that clonal spread of resistant TB strains, particularly of the Beijing lineage, is a root of the so far uncontroled MDR-TB epidemic in Central Asia.

Place, publisher, year, edition, pages
BMC , 2019. Vol. 19, article id 908
Keywords [en]
Molecular typing, MIRU, MDR-TB, Beijing, Cluster
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:uu:diva-400677DOI: 10.1186/s12879-019-4480-7ISI: 000500564800003PubMedID: 31664926OAI: oai:DiVA.org:uu-400677DiVA, id: diva2:1382190
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Swedish Research CouncilAvailable from: 2020-01-02 Created: 2020-01-02 Last updated: 2020-01-02Bibliographically approved

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