Transborder molecular analysis of drug‐resistant tuberculosis in Mongolia and Eastern Siberia, Russia

Abstract

Eastern Siberia (Russia) and Mongolia are borderline regions in Asia with a high incidence of tuberculosis (TB). In this study, we investigated the transborder transmission of Mycobacterium tuberculosis with a focus on endemic and epidemic clones and drug resistance. M. tuberculosis isolates (287 from Mongolia and 754 from Russia) were collected using cross‐sectional population‐based surveys between 2010 and 2016. The isolates were genotyped using 24 variable number of tandem repeat loci and by testing of the key markers to discriminate within the Beijing genotype. All isolates were divided into 427 mycobacterial interspersed repetitive units types that were assigned to Lineage 2 (Beijing) and Lineage 4 (Ural, Haarlem, Latin American‐Mediterranean [LAM], S, unclassified). The Beijing genotype was dominant in both countries (69% in Russia, 75% in Mongolia). However, the Beijing isolates differed significantly between the countries, in terms of the identified subtypes. LAM was the most common non‐Beijing genotype (11.1% in Mongolia and 14.9% in Russia) and LAM isolates mostly belonged to the LAM‐RUS branch in both countries. The multidrug‐resistance (MDR) rate was higher in Russia than in Mongolia among newly diagnosed patients: 29.4% versus 5.6% (p < .001). In Mongolia, the MDR rate was similar in Beijing (29.7%) and non‐Beijing (27.5%) genotypes. In Russia, a higher MDR rate was observed in (i) Beijing compared with non‐Beijing (48.7% versus 38.3%, p = .03) and (ii) Beijing B0/W148 compared with Beijing Central Asian/Russian (63.4% versus 37.3%, p < .001). In conclusion, the M. tuberculosis population structure in Mongolia was shaped by mainly historical interaction with China (dominance of the Beijing genotype) and Northern Eurasia (presence of the LAM‐RUS branch). In contrast, the transborder transmission of M. tuberculosis since the 1990s between Mongolia and its neighbours has been negligible, and the adverse trends of MDR‐TB in Russia did not impact the current situation in Mongolia.

Genetic Diversity and Primary Drug Resistance of Mycobacterium tuberculosis Beijing Genotype Strains in Northwestern Russia

“…All Beijing variants identified herein (except for CAO) are endemic Russian strains [ 7 , 12 , 18 , 21 , 22 , 23 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. In this study, the vast majority of B0/W148 strains (88.3%) were assigned to four clusters of the CC2 clonal complex: 100-32 (86.8%), 4737-32, 1075-32, and 9378-32.…”

“…The majority of these strains (79.0%) were assigned to 15 MIRU-VNTR types. Types 95-32 (6.8%; 12), 1065-32 (9.7%; 17), and the largest 94-32 (42.6%; 75) are widely distributed across the Russian Federation and post-Soviet countries, particularly dominating in Kazakhstan [ 34 , 35 , 36 , 39 , 40 , 41 ] although in the latter case, the contribution of the CAO strain is not known. For example, in Uzbekistan, the Central Asian/Russian clade is almost exclusively represented by the CAO strains [ 43 ].…”

Population structure of Mycobacterium tuberculosis from referral clinics in Western Siberia, Russia: Before and during the Covid-19 pandemic

“…The dominance of the Beijing genotype is a known feature of the M. tuberculosis population in Russia. However, non-Beijing genotypes of the Euro-American lineage have also been described across Russia in the visible prevalence rate, collectively accounting for 45% to 70% in Northwestern and Central Russia ( Vyazovaya et al, 2020 ; Dubiley et al, 2010 ), and 31% in Eastern Siberia ( Zhdanova et al, 2022 ). In this sense, their very low prevalence in this study is remarkable although the increase from 5 to 12% was significant.…”

“…In its turn, the Beijing genotype in Russia is mostly represented by isolates of modern sublineage that mainly belong to the Russian epidemic strain Beijing B0/W148 and heterogeneous Central Asian Russian clade ( Mokrousov, 2013 ; Shitikov et al, 2017 ). Regarding Euro-American lineage, its Russian isolates mainly belong to the LAM, Ural, Haarlem, and T families ( Zhdanova et al, 2022 ; Pasechnik et al, 2018 ; Umpeleva et al, 2020 ; Sinkov et al, 2018 ; Chernyaeva et al, 2018 ; Dymova et al, 2011 ).…”

Molecular detection and phylogeography of the hypervirulent subtype of <i>Mycobacterium tuberculosis</i> Beijing 14717-15

“…3). 14717-15 [24]), из Омской области Западной Сибири (регион с небольшим, но постоянным присутствием штаммов Beijing 14717-15 в локальной популяции [14]), из Китая, Вьетнама и Японии (страны с достаточно высокой долей штаммов древних сублиний генотипа Beijing [18,22,23]…”