Recurrences of multidrug‐resistant tuberculosis: Strains involved, within‐host diversity, and fine‐tuned allocation of reinfections. Issue 2 (17th January 2021)

• Record Type: Journal Article
• Authors: Pérez‐Lago, Laura; Monteserin, Johana; Paul, Roxana; Maus, Sandra R.; Yokobori, Noemí; Herranz, Marta; Sicilia, Jon; Acosta, Fermín; Fajardo, Sandra; Chiner‐Oms, Álvaro; Matteo, Mario; Simboli, Norberto; Comas, Iñaki; Muñoz, Patricia; López, Beatriz; Ritacco, Viviana; García de Viedma, Darío
• Is Part Of: Transboundary and emerging diseases. Volume 69:Issue 2(2022)
• Page Start: 327
• Page End: 336
• Publication Date: 2021-01-17
• Subjects: clonal variants -- diversity -- MDR -- molecular epidemiology -- recurrences -- reinfection -- Tuberculosis -- WGS; Veterinary medicine -- Periodicals; 636.089
• DOI: 10.1111/tbed.13982
• Languages: English
• ISSNs: 1865-1674

Abstract

Abstract: Recurrent tuberculosis occurs due to exogenous reinfection or reactivation/persistence. We analysed 90 sequential MDR Mtb isolates obtained in Argentina from 27 patients with previously diagnosed MDR‐TB that recurred in 2018 (1–10 years, 2–10 isolates per patient). Three long‐term predominant strains were responsible for 63% of all MDR‐TB recurrences. Most of the remaining patients were infected by strains different from each other. Reactivation/persistence of the same strain caused all but one recurrence, which was due to a reinfection with a predominant strain. One of the prevalent strains showed marked stability in the recurrences, while in another strain higher SNP‐based diversity was observed. Comparisons of intra‐ versus inter‐patient SNP distances identified two possible reinfections with closely related variants circulating in the community. Our results show a complex scenario of MDR‐TB infections in settings with predominant MDR Mtb strains.