Discrepancy in the transmissibility of multidrug-resistant mycobacterium tuberculosis in urban and rural areas in China. Issue 1 (31st December 2023)

• Record Type: Journal Article
• Authors: Li, Meng; Lu, Liping; Guo, Mingcheng; Jiang, Qi; Xia, Lan; Jiang, Yuan; Zhang, Shu; Qiu, Yong; Yang, Chongguang; Chen, Yiwang; Hong, Jianjun; Guo, Xiaoqin; Takiff, Howard; Shen, Xin; Chen, Chuang; Gao, Qian
• Is Part Of: Emerging microbes & infections. Volume 12:Issue 1(2023)
• Publication Date: 2023-12-31
• Subjects: Multidrug-resistant tuberculosis -- transmissibility -- whole-genome sequencing -- urban and rural China -- TB control programmes; Medical microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.9041
• DOI: 10.1080/22221751.2023.2192301
• Languages: English
• ISSNs: 2222-1751

Abstract

ABSTRACT: The fitness of multidrug-resistant tuberculosis (MDR-TB) is thought to be an important determinant of a strain's ability to be transmitted. Studies in the laboratory have demonstrated that MDR-TB strains have reduced fitness but the relative transmissibility of MDR-TB versus drug-susceptible (DS) TB strains in human populations remains unresolved. We used data on genomic clustering from our previous molecular epidemiological study in Songjiang (2011-2020) and Wusheng (2009-2020), China, to compare the relative transmissibility of MDR-TB versus DS-TB. Genomic clusters were defined with a threshold distance of 12-single-nucleotide-polymorphisms and the risk for MDR-TB clustering was analyzed by logistic regression. In total, 2212 culture-positive pulmonary TB patients were enrolled in Songjiang and 1289 in Wusheng. The clustering rates of MDR-TB and DS-TB strains were 19.4% (20/103) and 26.3% (509/1936), respectively in Songjiang, and 43.9% (29/66) and 26.0% (293/1128) in Wusheng. The risk of MDR-TB clustering was 2.34 (95% CI 1.38-3.94) times higher than DS-TB clustering in Wusheng and 0.64 (95% CI 0.38-1.06) times lower in Songjiang. Neither lineage 2, compensatory mutations nor rpoB S450L were significantly associated with MDR-TB transmission, and katG S315 T increased MDR-TB transmission only in Wusheng (OR 5.28, 95% CI 1.42-19.21). MDR-TB was not more transmissible than DS-TB in either Songjiang or Wusheng. It appears that the different transmissibility of MDR-TB in Songjiang and Wusheng is likely due to differences in the quality of the local TB control programmes. Suggesting that the most effective way to control MDR-TB is by improving local TB control programmes.