Phylogenetic population structureand drug resistanceof Mycobacterium tuberculosis complex in the Volta Region of Ghana

Abstract

ContextAvailable molecular epidemiological data from recent studies suggest significant genetic variation between the different phylogenetic lineages of Mycobacterium tuberculosis complex (MTBC) and the MTBC lineages might have adapted to different human populationsAimThis study sought to determine the phylogenetic population structure of clinical MTBC isolates from the Volta Region of Ghana.MethodsThe MTBC isolates obtained from collected sputum samples were characterized by standard methods. Non-tuberculous mycobacterial isolates were characterized by amplification of the heat shock protein 65 (hsp65) gene and sequencing. The drug susceptibility profiles of the MTBCs determined using GenoType MTBDRplusResultsOne hundred and seventeen (117, 93.6%) out of 125 mycobacterial positive isolates were characterized as members of the MTBC of which M. tuberculosis sensu stricto (MTBss) and M. africanum (Maf) were respectively 94 (80.3%) and 23 (19.7%). In all, 39 distinct spoligotype patterns were obtained; 26 for MTBss and 13 for Maf lineages. Spoligotyping identified 89 (76.04 %) Lineage 4, 16 (13.7 %) Lineage 5, 7 (6.0%) Lineage 6, 3 (2.6%) Lineage 2, 1(0.9%) Lineage 3 and 1 (0.9%) Lineage 1. Among the Lineage 4 isolates, 62/89 (69.7%) belonged to Cameroon sub-lineage, 13 (14.6%) Ghana, 8 (9.0%) Haarlem, 2 (2.2%) LAM, 1 (1.1%) Uganda I, 1 (1.1%) X and the remaining two were orphan. Significant localization of Maf was found within the Ho municipality (n=13, 29.5%) compared to the more cosmopolitan Ketu-South/Aflao (n=3, 8.3%) (p-value= 0.017). Eight (8) non-tuberculous mycobacteria were characterized as M. abscessus (7) and M. fortuitum (1)ConclusionWe confirmed the importance of M. africanum lineages as a cause of TB in the Volta region of Ghana.Key MessageThe phylogenetic population structure obtained agrees with previously described prevalence of M. tuberculosis complex phylogenetic lineages from other regions of Ghana. It also confirms the stable prevalence of M. africanum as an important human TB causing pathogen in Ghana.