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

作者：Perez Lago L; Izco S; Herranz M; Tudo G; Carcelen M; Comas I; Sierra O; Gonzalez Martin J; Ruiz Serrano M J; Eyene J; Bouza E; Garcia de Viedma D

来源：Clinical Microbiology and Infection, 2017, 23(2): 92-97.

DOI：10.1016/j.cmi.2016.10.006

• Emergence
• Equatorial Guinea
• MDR
• Screening
• Tuberculosis

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 variabilityd-six single nucleotide polymorphisms acquired by this strain over 15 yearsd-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.

• 出版日期2017-2