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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.
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Details
1 Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Science, Shanghai Medical College, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University , Shanghai , People’s Republic of China, National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital , Shenzhen , People’s Republic of China
2 Department of Tuberculosis Control, Songjiang District Center for Disease Control and Prevention , Shanghai , People’s Republic of China
3 Department of Tuberculosis Control, Wusheng County Center for Disease Control and Prevention , Guang’an , People’s Republic of China
4 School of Public Health, Renmin Hospital Public Health Research Institute, Wuhan University , Wuhan , People’s Republic of China
5 Sichuan Provincial Center for Disease Control and Prevention, Institution for Tuberculosis Prevention and Control , Chengdu , People’s Republic of China
6 Tuberculosis Laboratory, Shanghai Municipal Center for Disease Control and Prevention , Shanghai , People’s Republic of China
7 Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), School of Basic Medical Science, Shanghai Medical College, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University , Shanghai , People’s Republic of China, School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University , Shenzhen , People’s Republic of China
8 Laboratorio de Genética Molecular, CMBC, IVIC , Caracas , Venezuela