A novel strategy based on genomics and specific PCR reveals how a multidrug-resistant Mycobacterium tuberculosis strain became prevalent in Equatorial Guinea 15 years after its emergence. (February 2017)

• Record Type: Journal Article
• Authors: Pérez-Lago, L.; Izco, S.; Herranz, M.; Tudó, G.; Carcelén, M.; Comas, I.; Sierra, O.; González-Martín, J.; Ruiz-Serrano, M.J.; Eyene, J.; Bouza, E.; García de Viedma, D.
• Is Part Of: Clinical microbiology and infection. Volume 23:Number 2(2017)
• Page Start: 92
• Page End: 97
• Publication Date: 2017-02
• Subjects: Emergence -- Equatorial Guinea -- MDR -- Screening -- Tuberculosis; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2016.10.006
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Objective: Molecular epidemiology techniques in tuberculosis (TB) can identify high-risk strains that are actively transmitted. We aimed to implement a novel strategy to optimize the identification and control of multidrug-resistant (MDR) TB in a specific population. Methods: We developed a strain-specific PCR tailored from whole genome sequencing (WGS) data to track a specific MDR prevalent strain in Equatorial Guinea (EG-MDR). Results: The PCR was applied prospectively on remnants of GeneXpert reaction mixtures owing to the lack of culture facilities in Equatorial Guinea. In 147 (93%) of 158 cases, we were able to differentiate between infection by the EG-MDR strain or by any other strain and found that 44% of all rifampicin-resistant TB cases were infected by EG-MDR. We also analysed 93 isolates obtained from Equatorial Guinea 15 years ago, before MDR-TB had become the problem it is today. We found that two of the scarce historical MDR cases were infected by EG-MDR. WGS revealed low variability—six single nucleotide polymorphisms acquired by this strain over 15 years—likely because of the lack in the country of a specific program to treat MDR-TB. Conclusions: Our novel strategy, which integrated WGS analysis and strain-specific PCRs, represents a low-cost, rapid and transferable strategy that allowed a prospective efficient survey and fast historical analysis of MDR-TB in a population.