High within-host diversity found from direct genotyping on post-mortem tuberculosis specimens in a high-burden setting. (October 2021)

• Record Type: Journal Article
• Authors: Rodríguez-Grande, Cristina; Hurtado, Juan Carlos; Rodríguez-Maus, Sandra; Casas, Isaac; Castillo, Paola; Navarro, Mireia; Rakislova, Natalia; García-Basteiro, Alberto; Carrilho, Carla; Fernandes, Fabiola; Lovane, Lucilia; Jordao, Dercio; Ismail, Mamudo R.; Lorenzoni, Cesaltina; Cossa, Anélsio; Mandomando, Inácio; Bassat, Quique; Menéndez, Clara; Ordi, Jaume; Muñoz, Patricia; Pérez-Lago, Laura; García de Viedma, Darío; Martínez, Miguel J.
• Is Part Of: Clinical microbiology and infection. Volume 27:Number 10(2021)
• Page Start: 1518.e5
• Page End: 1518.e9
• Publication Date: 2021-10
• Subjects: Clonal complexity -- Genotyping -- Mozambique -- Post-mortem -- Tuberculosis; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2021.05.038
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Objectives: To characterize the clonal complexity in Mycobacterium tuberculosis (MTB) infections considering factors that help maximize the detection of coexisting strains/variants. Methods: Genotypic analysis by Mycobacterial Interspersed Repetitive-Unit–Variable-Number Tandem-Repeats (MIRU-VNTR) was performed directly on 70 biopsy specimens from two or more different tissues involving 28 tuberculosis cases diagnosed post-mortem in Mozambique, a country with a high tuberculosis burden. Results: Genotypic data from isolates collected from two or more tissues were obtained for 23 of the 28 cases (82.1%), allowing the analysis of within-patient diversity. MIRU-VNTR analysis revealed clonal diversity in ten cases (35.7%). Five cases showed allelic differences in three or more loci, suggesting mixed infection with two different strains. In half of the cases showing within-host diversity, one of the specimens associated with clonal heterogeneity was brain tissue. Conclusions: Direct MTB genotyping from post-mortem tissue samples revealed a frequent within-host Mycobacterium tuberculosis diversity, including mixed and polyclonal infections. Most of this diversity would have been overlooked if only standard analysis of respiratory specimens had been performed.