Genotypic diversity of <i>Mycobacterium tuberculosis</i> strains in Myanmar

Tun, Thanda; Aye, Khin Saw; Nyunt, Wint Wint; Crump, John A.; Nakajima, Chie; Suzuki, Yasuhiko; Thinn, Kyi Kyi; Cook, Gregory M.; Aung, Htin

doi:10.1080/23744235.2016.1231419

Cited by 6 publications

(10 citation statements)

References 6 publications

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“…[33–35] The genetic diversity of MTB in Myanmar is mainly driven by both the EAI and the Beijing subfamilies. [36,37] In this study, most patients have the EAI lineage followed by the Beijing, which concurred with those results.…”

Section: Discussionsupporting

confidence: 91%

Infection of multiple Mycobacterium tuberculosis strains among tuberculosis/human immunodeficiency virus co-infected patients: A molecular study in Myanmar

Kyi

Palittapongarnpim

Chaiprasert

et al. 2018

Int J Mycobacteriol

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Background: Appearance of Mycobacterium tuberculosis (MTB) in the sputum of a tuberculosis (TB)/human immunodeficiency virus (HIV) co-infected patient under treatment may indicate either failure or new infection. This study aims to evaluate whether TB treatment failure among TB/HIV co-infected patients is a real failure. Methods: A prospective cohort study was conducted among 566 TB/HIV co-infected patients who started TB treatment in 12 townships in the upper Myanmar. Among the 566 participants, 16 (2.8%) resulted in treatment failure. We performed a molecular study using mycobacterial interspersed repetitive-unit-variable number of tandem repeat (MIRU-VNTR) genotyping for them. The MIRU-VNTR profiles were analyzed using the web server, MIRU-VNTRplus. All data were entered into EpiData version 3.1 and analyzed using R version 3.4.3. Results: Among 16 failure patients, seven had incomplete laboratory results. Of the nine remaining patients, nobody had exactly the same MIRU-VNTR pattern between the initial and final isolates. Four patients had persistent East-African Indian (EAI) lineages and one each had persistent Beijing lineage, changing from EAI to Beijing, from Beijing to EAI, NEW-1 to Beijing, and NEW-1 to X strains. Female patients have significantly larger genetic difference between MTB of the paired isolates than male patients (t-test, P = 0.04). Conclusion: Thus, in our study patients, infection of multiple MTB strains is a possible cause of TB treatment failure. Explanation for the association between gender and distance of genotypes from the initial to subsequent MTB infection needs further studies.

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Section: Discussionsupporting

confidence: 91%

Infection of multiple Mycobacterium tuberculosis strains among tuberculosis/human immunodeficiency virus co-infected patients: A molecular study in Myanmar

Kyi

Palittapongarnpim

Chaiprasert

et al. 2018

Int J Mycobacteriol

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“…The relationship of Beijing genotype and drug resistance may have a certain tendency for acquiring drug resistance which seems to be widely distributed (but not universal) [24]. In Myanmar, other previous studies have described that the Beijing genotypes in MDR and XDR populations are highly prevalent [25,26]. In the present study, the association between Beijing strains and MDR was highly significance (pvalue < 0.001).…”

Section: Discussionsupporting

confidence: 52%

Genetic diversity of Mycobacterium tuberculosis using 24-locus MIRU-VNTR typing and Spoligotyping in Upper Myanmar

Sann

Namwat

Faksri

et al. 2020

J Infect Dev Ctries

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Introduction: MIRU-VNTR typing and Spoligotyping are the useful molecular tools for TB epidemiology study. Information regarding genetic diversity and tuberculosis (TB) transmission in Upper Myanmar only is scares. Methodology: We determined the genetic diversity of Mycobacterium tuberculosis (Mtb) and TB transmission from Upper Myanmar TB Reference Laboratory, Mandalay Region, including Mandalay (72), Shan (22), Magway (15), Sagaing (13), Nay Pyi Taw (8), Kachin (7), Chin (2) and Kayah (1). One hundred and forty Mtb isolates were genotyped using 24-locus MIRU-VNTR typing and spoligotyping. Lineage classification and TB transmission analysis were performed. Results: 24-locus MIRU-VNTR typing identified 135 unique profiles and two clusters compared to 35 spoligotyping profiles which contained 12 clusters and 23 unique isolates, Beijing (n=100, 71.4%) was found to be prominent lineage by combine two methods. The expected proportion attributable to recent transmission based on clustering rate was 2.1%. One cluster case was more likely to be in MDR patient. Conclusions: Our findings showed Beijing genotypes were dominant in Upper Myanmar. The usage and analysis of 24-locus MIRU-VNTR typing might prove useful for our broader understanding of TB outbreaks and epidemiology than spoligotyping. The genotypic pattern of this combined method suggests that the lower transmission rate may be due to a higher possibility of reactivation cases in Upper Myanmar.

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“…Table 7 compares the distribution of lineage of MTB from our study with that from other studies [ 9 , 11 , 19 , 27 ]. L1 lineage was the most dominant in our and the Philippines study but in detail, the sublineage pattern was different [ 11 ].…”

Section: Discussionmentioning

confidence: 95%

“…L1 lineage was the most dominant in our and the Philippines study but in detail, the sublineage pattern was different [ 11 ]. L2 lineage was very prominent in a study from Yangon Region, Myanmar [ 19 ]. This difference between lineage distribution of our study and the Yangon study suggests that transmission of TB in border areas has relatively little communication with the Yangon Region.…”

Section: Discussionmentioning

confidence: 99%

“…For sample size calculation, we used the finite population proportion sample size formula. n = N p (1 − p )z 2 1 − α/2 / d 2 ( N − 1) + p (1 − p )z 2 1 − α/2 where p is the proportion of the most frequent lineage strain among pulmonary sputum smear-positive TB patients (0.76) based on a previous study [ 19 ], d is the precision (0.08), and α is the type I error rate (0.05). With these parameters, a minimum of 104 WGS TB isolates from TB patients were required.…”

Section: Methodsmentioning

confidence: 99%

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Geno-Spatial Distribution of Mycobacterium Tuberculosis and Drug Resistance Profiles in Myanmar–Thai Border Area

et al. 2020

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Worldwide, studies investigating the relationship between the lineage of Mycobacterium tuberculosis (MTB) across geographic areas has empowered the “End TB” program and understand transmission across national boundaries. Genomic diversity of MTB varies with geographical locations and ethnicity. Genomic diversity can also affect the emergence of drug resistance. In Myanmar, we still have limited genetic information about geographical, ethnicity, and drug resistance linkage to MTB genetic information. This study aimed to describe the geno-spatial distribution of MTB and drug resistance profiles in Myanmar–Thailand border areas. A cross-sectional study was conducted with a total of 109 sequenced isolates. The lineages of MTB and the potential associated socio-demographic, geographic and clinical factors were analyzed using Fisher’s exact tests. p value of statistically significance was set at < 0.05. We found that 67% of the isolates were lineage 1 (L1)/East-African-Indian (EAI) (n = 73), followed by lineage 2 (L2)/Beijing (n = 26), lineage 4 (L4)/European American (n = 6) and lineage 3 (L3)/Delhi/Central Asian (n = 4). “Gender”, “type of TB patient”, “sputum smear grading” and “streptomycin resistance” were significantly different with the lineages of MTB. Sublineages of L1, which had never been reported elsewhere in Myanmar, were detected in this study area. Moreover, both ethnicity and lineage of MTB significantly differed in distribution by patient location. Diversity of the lineage of MTB and detection of new sublineages suggested that this small area had been resided by a heterogeneous population group who actively transmitted the disease. This information on distribution of lineage of MTB can be linked in the future with those on the other side of the border to evaluate cross-border transmission.

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Genotypic diversity of Mycobacterium tuberculosis strains in Myanmar

Cited by 6 publications

References 6 publications

Infection of multiple Mycobacterium tuberculosis strains among tuberculosis/human immunodeficiency virus co-infected patients: A molecular study in Myanmar

Infection of multiple Mycobacterium tuberculosis strains among tuberculosis/human immunodeficiency virus co-infected patients: A molecular study in Myanmar

Genetic diversity of Mycobacterium tuberculosis using 24-locus MIRU-VNTR typing and Spoligotyping in Upper Myanmar

Geno-Spatial Distribution of Mycobacterium Tuberculosis and Drug Resistance Profiles in Myanmar–Thai Border Area

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