The Association between Mycobacterium Tuberculosis Genotype and Drug Resistance in Peru.


Grandjean, L; Iwamoto, T; Lithgow, A; Gilman, RH; Arikawa, K; Nakanishi, N; Martin, L; Castillo, E; Alarcon, V; Coronel, J; Solano, W; Aminian, M; Guezala, C; Rastogi, N; Couvin, D; Sheen, P; Zimic, M; Moore, DA; (2015) The Association between Mycobacterium Tuberculosis Genotype and Drug Resistance in Peru. PLoS One, 10 (5). e0126271. ISSN 1932-6203 DOI: 10.1371/journal.pone.0126271

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Abstract

The comparison of Mycobacterium tuberculosis bacterial genotypes with phenotypic, demographic, geospatial and clinical data improves our understanding of how strain lineage influences the development of drug-resistance and the spread of tuberculosis. To investigate the association of Mycobacterium tuberculosis bacterial genotype with drug-resistance. Drug susceptibility testing together with genotyping using both 15-loci MIRU-typing and spoligotyping, was performed on 2,139 culture positive isolates, each from a different patient in Lima, Peru. Demographic, geospatial and socio-economic data were collected using questionnaires, global positioning equipment and the latest national census. The Latin American Mediterranean (LAM) clade (OR 2.4, p<0.001) was significantly associated with drug-resistance and alone accounted for more than half of all drug resistance in the region. Previously treated patients, prisoners and genetically clustered cases were also significantly associated with drug-resistance (OR's 2.5, 2.4 and 1.8, p<0.001, p<0.05, p<0.001 respectively). Tuberculosis disease caused by the LAM clade was more likely to be drug resistant independent of important clinical, genetic and socio-economic confounding factors. Explanations for this include; the preferential co-evolution of LAM strains in a Latin American population, a LAM strain bacterial genetic background that favors drug-resistance or the "founder effect" from pre-existing LAM strains disproportionately exposed to drugs.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Antimicrobial Resistance Centre (AMR)
TB Centre
PubMed ID: 25984723
Web of Science ID: 354917300036
URI: http://researchonline.lshtm.ac.uk/id/eprint/2172781

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