Tuberculosis outcomes related to the Mycobacterium tuberculosis genotype
- Authors: Pasechnik O.A.1, Vyazovaya A.A.2, Dymova M.A.3, Blokh A.I.1, Stasenko V.L.1, Tatarintseva M.P.4, Mokrousov I.V.2
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Affiliations:
- Omsk State Medical University
- St. Petersburg Pasteur Institute
- Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences
- Clinical Tuberculosis Dispensary
- Issue: Vol 9, No 3-4 (2019)
- Pages: 531-538
- Section: ORIGINAL ARTICLES
- URL: https://journal-vniispk.ru/2220-7619/article/view/118778
- DOI: https://doi.org/10.15789/2220-7619-2019-3-4-531-538
- ID: 118778
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Abstract
Mycobacterium tuberculosis strains of different phylogenetic lineages and genetic families differ in biological properties that determine, to some extent, epidemiological features and clinical manifestation in tuberculosis (TB) patients.
The aim of the study was to assess the risk of an adverse outcome of the disease in TB patients caused by various M. tuberculosis genotypes.
Materials and methods. A total of 425 patients with respiratory TB were enrolled in this study. They were registered at phthisiatric facilities in the Omsk region from March 2015 to June 2017 period and included: males — 73.1%, mean age 39.9 years, females — 26.9%, mean age 42.0 years. M. tuberculosis culture and drug susceptibility testing and DNA extraction were performed in accordance with standard methods. Strains were assigned to the M. tuberculosis Beijing genotype and its epidemiologically relevant clusters B0/W148 and 94-32 by PCR based detection of specific markers. Non-Beijing strains were subjected to spoligotyping.
Results. We found that 66.5% isolates belonged to the Beijing genotype, 12.8% — to LAM, 10.1% — to T, and 4.7% — to the Ural genotype. Multi-drug resistance (MDR) to anti-TB drugs was observed in 195 M. tuberculosis strains (45.9%). Moreover, Beijing genotype was more often isolated from patients with MDR-TB infection (PR = 2.09 (95% CI 1.6–2.74) and TB infection associated with HIV infection (PR = 1.14 (95% CI 1.01–1.31). Lethal outcome was double higher in patients infected with Beijing vs. non-Beijing strains, 28.6% vs. 14.0% (PR = 2.03; 95% CI 1.3–3.17). The risk factors were identified as follows: young age 18–44 years (RR = 1.7; 95% CI 1.18–2.7), co-morbidity with HIV (RR = 5.0; 95% CI 3.39–7.45), multiple (RR = 1.7; 95% CI 1.14–2.55) and extensive drug resistance (RR = 2.57; 95% CI 1.35–4.92), and association with the Beijing genotype (RR = 2.0, 95% CI 1.3–3.17).
Conclusion. M. tuberculosis spread in the Omsk region is characterised by significant prevalence of the Beijing genotype, associated with multiple and extensive drug resistance. A significant association of adverse clinical outcomes and various factors, including association with the Beijing genotype, requires development of new approaches in the fight against tuberculosis.
About the authors
O. A. Pasechnik
Omsk State Medical University
Author for correspondence.
Email: opasechnik@mail.ru
PhD (Medicine), Senior Lecturer, Department of Epidemiology,
Omsk
Russian FederationA. A. Vyazovaya
St. Petersburg Pasteur Institute
Email: elmtree2001@mail.ru
PhD (Biology), Senior Researcher, Laboratory of Molecular Epidemiology and Evolutionary Genetics,
St. Petersburg
Russian FederationM. A. Dymova
Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences
Email: maya.a.rot@gmail.com
PhD (Biology), Senior Researcher, Laboratory of Biotechnology,
Novosibirsk
Russian FederationA. I. Blokh
Omsk State Medical University
Email: spy_spirit@mail.ru
Assistant Professor, Department of Epidemiology,
Omsk
Russian FederationV. L. Stasenko
Omsk State Medical University
Email: vlstasenko@yandex.ru
PhD, MD (Medicine), Professor, Head of the Department of Epidemiology,
Omsk
Russian FederationM. P. Tatarintseva
Clinical Tuberculosis Dispensary
Email: buzoo_kptd@mail.ru
Head of the Clinical Tuberculosis Dispensary,
Omsk
Russian FederationI. V. Mokrousov
St. Petersburg Pasteur Institute
Email: imokrousov@mail.ru
PhD, MD (Biology), Head of the Laboratory of Molecular Epidemiology and Evolutionary Genetics,
St. Petersburg
Russian FederationReferences
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