Impact of Mycobacterium tuberculosis complex lineages as a determinant of disease phenotypes from an immigrant rich moderate tuberculosis burden country

Abstract

BackgroundGrowing evidences suggested that the Mycobacterium tuberculosis complex (MTBC) lineages can determine the clinical outcome of pulmonary and extra-pulmonary tuberculosis. However, limited data only available revealing such association of bacterial genotypes and clinical phenotypes from immigrant rich countries.MethodsA multicenter study has been carried out on a collection of 2092 (1003 extrapulmonary and 1089 pulmonary) MTBC isolates. Genotyping of all the isolates were carried out by spoligotyping and 24 loci based MIRU-VNTR typing.ResultsDemographically domination of young Saudi nationals (61.4%) and men (61.2%) were found in this cohort. Lymph nodes (62.4%) and gastrointestinal sites (16.7%) were the most common anatomical sites of infection. The predominant lineages were Delhi/CAS (26.9%), EAI (14.2%) and Ghana (9.9%). Mycobacterium africanum type I and II were reported for the first time in the country among extrapulmonary cases. ‘Ancestral’ lineages M.bovis (OR-5.22; 95% CI-2.23-8.22, p- < 0.001) and Delhi/CAS (OR-0.57; 95% CI-0.411-0.734, p- < 0.001) were directly associated with lymph node tuberculosis and gastrointestinal tuberculosis (M. bovis-OR-0.33; 95% CI-0.085-0.567, p-0.001 and Delhi/CAS-OR-1.87; 95% CI-1.22-2.53, p- < 0.001) respectively. Among the ‘Modern’ lineages, EAI showed significant association to central nervous system tuberculosis (OR-1.98; 95% CI-0.76-3.19, p-0.04) and Uganda-I to gastrointestinal tuberculosis (OR-2.41; 95% CI-0.77-4.06, p-0.02).ConclusionsThe findings substantially contribute to the emerging evidences that MTBC lineages influence disease phenotypes and epidemiological consequences.Electronic supplementary materialThe online version of this article (10.1186/s12931-018-0966-x) contains supplementary material, which is available to authorized users.

Demographic risk factors for extra-pulmonary tuberculosis among adolescents and adults in Saudi Arabia

“…Regression analysis of demographical factors against site of EPTB infections showed male-gender as an independent risk factor to lymph node TB (Table 2). While similar findings have been recently established in Saudi Arabia on a national scale [25, 26], several previous reports documented increased risk of females to lymph node TB in different geographical regions [27–31]. Variations in immune-related factors (e.g.…”

TbD1 deletion as a driver of the evolutionary success of modern epidemic Mycobacterium tuberculosis lineages

“…The TbD1-intact L1 strains are prevalent in South India and South East Asia 5 , while L7 strains are restricted to the region around the Horn of Africa [16][17][18] . The L1 strains can be subdivided in numerous sublineages 19,20 and can cause pulmonary TB as well as extrapulmonary TB in susceptible populations 21,22 . Several reports have suggested that Mtb strains from different lineages may induce unalike host responses [23][24][25][26] .…”

Molecular diagnosis, genetic diversity and drug sensitivity patterns of Mycobacterium tuberculosis strains isolated from tuberculous meningitis patients at a tertiary care hospital in South India

“…The predominant genotype among our TBM cases in South India was that of EAI lineage (n = 16, 72.7%) followed by Beijing (n = 3, 13.6%), S-family (n = 2, 9.1%) and Delhi/CAS (n = 1, 4.5%). A study from Varghese et al reported that EAI displayed significant association to CNS TB (p-0.04) [30]. The EAI lineage strains are the most ancient Mtb strain found mostly in the southern part of India, particularly prevalent in tropical countries.…”

“…A study from Varghese et al . reported that EAI displayed significant association to CNS TB (p-0.04) [ 30 ]. The EAI lineage strains are the most ancient Mtb strain found mostly in the southern part of India, particularly prevalent in tropical countries.…”