Anti-tuberculosis drug resistance in Slovakia, 2018–2019: The first whole-genome epidemiological study

Dohál, Matúš; Dvořáková, Věra; Šperková, Miluše; Porvazník, Igor; Cabibbe, Andrea Maurizio; Trovato, Alberto; Spitaleri, Andrea; Rasmussen, Erik Michael; Pršo, Kristián; Škereňová, Mária; Cirillo, Daniela María; Solovič, Ivan; Mokrý, Juraj

doi:10.1016/j.jctube.2021.100292

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…Previous studies conducted in Ukraine, the Russian Federation and other Central Asian countries showed similar results [ 25 – 27 ]. The results also showed changes in the distribution of lineages in Slovakia, with a predominance of the Beijing lineage, which occurred in only 2 patients over the last 6 years [ 16 ]. As this lineage is characterized by increased virulence and transmissibility, we strongly recommend public health authorities to take the necessary measures, such as a thorough investigation of close contacts, as early detection facilitates rapid initiation of an appropriate treatment regimen [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

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Tuberculosis in Ukrainian War Refugees and Migrants in the Czech Republic and Slovakia: A Molecular Epidemiological Study

Dohál,

Dvořáková,

Šperková

et al. 2023

J Epidemiol Glob Health

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Background The war in Ukraine has led to significant migration to neighboring countries, raising public health concerns. Notable tuberculosis (TB) incidence rates in Ukraine emphasize the immediate requirement to prioritize approaches that interrupt the spread and prevent new infections. Methods We conducted a prospective genomic surveillance study to assess migration's impact on TB epidemiology in the Czech Republic and Slovakia. Mycobacterium tuberculosis isolates from Ukrainian war refugees and migrants, collected from September 2021 to December 2022 were analyzed alongside 1574 isolates obtained from Ukraine, the Czech Republic, and Slovakia. Results Our study revealed alarming results, with historically the highest number of Ukrainian tuberculosis patients detected in the host countries. The increasing number of cases of multidrug-resistant TB, significantly linked with Beijing lineage 2.2.1 (p < 0.0001), also presents substantial obstacles to control endeavors. The genomic analysis identified the three highly related genomic clusters, indicating the recent TB transmission among migrant populations. The largest clusters comprised war refugees diagnosed in the Czech Republic, TB patients from various regions of Ukraine, and incarcerated individuals diagnosed with pulmonary TB specialized facility in the Kharkiv region, Ukraine, pointing to a national transmission sequence that has persisted for over 14 years. Conclusions The data showed that most infections were likely the result of reactivation of latent disease or exposure to TB before migration rather than recent transmission occurring within the host country. However, close monitoring, appropriate treatment, careful surveillance, and social support are crucial in mitigating future risks, though there is currently no evidence of local transmission in EU countries.

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Section: Discussionmentioning

confidence: 99%

“…DNA extraction and WGS were performed as mentioned above (see section Ukrainian refugees and migrants). Twelve MDR and pre-XDR isolates have been described previously (accession number PRJEB43174) [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Tuberculosis in Ukrainian War Refugees and Migrants in the Czech Republic and Slovakia: A Molecular Epidemiological Study

Dohál,

Dvořáková,

Šperková

et al. 2023

J Epidemiol Glob Health

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“…TB control efforts of low-incidence regions can be compromised due to transmission events between native patients and immigrants with drug-resistant Mycobacterium tuberculosis (MTB) isolates, especially MDR-TB isolates. Some studies have reported transmission events between native patients and foreign patients with MDR-TB isolates in Germany, Switzerland, Slovakia, and Belgium using whole-genome sequencing (WGS) [7][8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Transmission of drug-resistant Mycobacterium tuberculosis isolates between Finnish- and foreign-born patients, 2014-2021: a molecular epidemiological study

Zhu

Haanperä

Mentula

et al. 2023

Preprint

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Background Data on the molecular epidemiological characteristics and transmission of drug-resistant Mycobacterium tuberculosis (MTB) isolates in low-incidence settings with immigration from high-incidence settings are limited.Method We included 101 drug-resistant MTB isolates with whole-genome sequencing data isolated in Finland between 2014 and 2021. Mutations associated with resistance to first- and second-line drugs were identified. Potential transmission clusters were identified using a threshold of 12 single-nucleotide polymorphisms (SNPs). Highly related clusters were identified using a threshold of 5 SNPs.Result Of the 101 drug-resistant MTB isolates, 29 (28.7%) isolates were from Finnish-born persons and 72 (71.3%) were from foreign-born persons. The proportion of foreign-born persons with multidrug-resistant (MDR) MTB (25/72, 34.7%) was higher than that in Finnish-born persons (6/29, 20.7%). The most common mutation associated with resistance to INH and RIF was katG Ser315Thr (67/83, 80.7%) and rpoB Ser450Leu (29/35, 82.9%), respectively. Lineage 4 (36/101, 35.6%) and lineage 2 (35/101, 34.6%) were prevalent lineages. A total of 16 (15.8%) isolates were classified into 7 potential transmission clusters (≤ 12 SNPs). Furthermore, one highly related cluster (≤ 5 SNPs) was identified, including one MDR isolate from a Finnish-born person and another MDR isolate from a person born in eastern Europe.Conclusion Transmission of drug-resistant MTB isolates between native and foreign-born persons is limited in Finland. Monitoring transmission dynamics of drug-resistant TB is of importance to inform tuberculosis management and control in low-incidence settings with increasing immigration.

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“…The illness affects the respiratory tract in so‐called pulmonary TB and the extrapulmonary form of the disease is recognized in M. tuberculosis infection sites other than the lungs. In the Slovak Republic, a low TB burden country, the incidence of both drug‐susceptible and drug‐resistant forms of TB remains relatively stable 2,3 …”

Section: Introductionmentioning

confidence: 99%

“…In the Slovak Republic, a low TB burden country, the incidence of both drug‐susceptible and drug‐resistant forms of TB remains relatively stable. 2 , 3 …”

Section: Introductionmentioning

confidence: 99%

A high‐throughput LC–MS/MS method for simultaneous determination of isoniazid, ethambutol and pyrazinamide in human plasma

Pršo

Žideková

Porvazník³

et al. 2022

Rapid Comm Mass Spectrometry

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Rationale Tuberculosis (TB) remains a challenging global infectious disease, mainly affecting the lungs. First‐line anti‐TB drugs play a crucial role in slowing down the rapid spread of TB. In addition, the patient might benefit from therapeutic drug monitoring since it has become an accepted clinical tool for optimizing TB treatment. Methods A simple and sensitive liquid chromatography/tandem mass spectrometry method was developed to monitor the plasma level of isoniazid, ethambutol and pyrazinamide in plasma samples. A one‐step extraction procedure using an Ostro™ plate was applied, and extracts were analyzed by gradient elution followed by detection on a mass spectrometer by multiple reaction monitoring mode. Results The analytes were separated within 4.2 min and over the concentration range of 0.2–10 μg/ml for isoniazid and ethambutol and 1–65 μg/ml for pyrazinamide. The method was successfully validated according to the European Medicine Agency guideline for the selectivity, linearity and lower limit of detection, precision and accuracy, matrix effect, extraction recovery, carryover, dilution integrity and stability, and applied for quantification of analytes in clinical samples from TB patients. Conclusions The presented method allows sensitive and reproducible determination of selected anti‐TB drugs with advantages such as low sample volume requirement, short run time of analysis, one‐step sample preparation procedure with capabilities for phospholipids removal, and a low quantification limit as well as a high degree of selectivity.

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Anti-tuberculosis drug resistance in Slovakia, 2018–2019: The first whole-genome epidemiological study

Cited by 4 publications

References 24 publications

Tuberculosis in Ukrainian War Refugees and Migrants in the Czech Republic and Slovakia: A Molecular Epidemiological Study

Tuberculosis in Ukrainian War Refugees and Migrants in the Czech Republic and Slovakia: A Molecular Epidemiological Study

Transmission of drug-resistant Mycobacterium tuberculosis isolates between Finnish- and foreign-born patients, 2014-2021: a molecular epidemiological study

A high‐throughput LC–MS/MS method for simultaneous determination of isoniazid, ethambutol and pyrazinamide in human plasma

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