Extensive global movement of multidrug-resistant M. tuberculosis strains revealed by whole-genome analysis

Extensive global movement of multidrug-resistant M. tuberculosis strains revealed by whole-genome analysis

Cohen, Keira A. (Johns Hopkins University)
Manson, Abigail L. (Broad Institute of MIT and Harvard)
Abeel, T.E.P.M.F. (TU Delft Pattern Recognition and Bioinformatics; Broad Institute of MIT and Harvard)
Desjardins, Christopher A. (Broad Institute of MIT and Harvard)
Chapman, Sinead B. (Broad Institute of MIT and Harvard)
Hoffner, Sven (Karolinska Institutet)
Birren, Bruce W. (Broad Institute of MIT and Harvard)
Earl, Ashlee M. (Broad Institute of MIT and Harvard)

2019

Background: While the international spread of multidrug-resistant (MDR) Mycobacterium tuberculosis strains is an acknowledged public health threat, a broad and more comprehensive examination of the global spread of MDR-tuberculosis (TB) using whole-genome sequencing has not yet been performed. Methods: In a global dataset of 5310 M. tuberculosis whole-genome sequences isolated from five continents, we performed a phylogenetic analysis to identify and characterise clades of MDR-TB with respect to geographic dispersion. Results: Extensive international dissemination of MDR-TB was observed, with identification of 32 migrant MDR-TB clades with descendants isolated in 17 unique countries. Relatively recent movement of strains from both Beijing and non-Beijing lineages indicated successful global spread of varied genetic backgrounds. Migrant MDR-TB clade members shared relatively recent common ancestry, with a median estimate of divergence of 13-27 years. Migrant extensively drug-resistant (XDR)-TB clades were not observed, although development of XDR-TB within migratory MDR-TB clades was common. Conclusions: Application of genomic techniques to investigate global MDR migration patterns revealed extensive global spread of MDR clades between countries of varying TB burden. Further expansion of genomic studies to incorporate isolates from diverse global settings into a single analysis, as well as data sharing platforms that facilitate genomic data sharing across country lines, may allow for future epidemiological analyses to monitor for international transmission of MDR-TB. In addition, efforts to perform routine whole-genome sequencing on all newly identified M. tuberculosis, like in England, will serve to better our understanding of the transmission dynamics of MDR-TB globally.

clinical epidemiology
tuberculosis

http://resolver.tudelft.nl/uuid:2cbcbc83-8d63-4d45-a262-02094e56e43e

https://doi.org/10.1136/thoraxjnl-2018-211616

0040-6376

Thorax, 74 (9), 882-889

Institutional Repository

journal article

© 2019 Keira A. Cohen, Abigail L. Manson, T.E.P.M.F. Abeel, Christopher A. Desjardins, Sinead B. Chapman, Sven Hoffner, Bruce W. Birren, Ashlee M. Earl