Insights into the Origin, Emergence, and Current Spread of a Successful Russian Clone of Mycobacterium tuberculosis

Abstract

SUMMARY Mycobacterium tuberculosis variant Beijing B0/W148 is regarded as a successful clone of M. tuberculosis that is widespread in the former Soviet Union and respective immigrant communities. Understanding the pathobiology and phylogeography of this notorious strain may help to clarify its origin and evolutionary history and the driving forces behind its emergence and current dissemination. I present the first review and analysis of all available data on the subject. In spite of the common perception of the omnipresence of B0/W148 across post-Soviet countries, its geographic distribution shows a peculiar clinal gradient. Its frequency peaks in Siberian Russia and, to a lesser extent, in the European part of the former Soviet Union. In contrast, the frequency of B0/W148 is sharply decreased in the Asian part of the former Soviet Union, and it is absent in autochthonous populations elsewhere in the world. Placing the molecular, clinical, and epidemiological features in a broad historical, demographic, and ecological context, I put forward two interdependent hypotheses. First, B0/W148 likely originated in Siberia, and its primary dispersal was driven by a massive population outflow from Siberia to European Russia in the 1960s to 1980s. Second, a historically recent, phylogenetically demonstrated successful dissemination of the Beijing B0/W148 strain was triggered by the advent and wide use of modern antituberculosis (anti-TB) drugs and was due to the remarkable capacity of this strain to acquire drug resistance. In contrast, there is some indication, but not yet systematic proof, of an enhanced virulence of this strain.

Urgent Implementation in a Hospital Setting of a Strategy To Rule Out Secondary Cases Caused by Imported Extensively Drug-Resistant Mycobacterium tuberculosis Strains at Diagnosis

“…The 9-signal Beijing spoligotype profile was also predicted using in silico typing based on short sequence reads. A comparison of the MIRU-VNTR patterns with those of strains circulating in Russia (St. Petersburg Pasteur Institute database) and with strains from the MIRUVNTRplus.org database indicated that they corresponded to the 100-32 type (Beijing B0/W148) clonal cluster, previously defined as a successful Russian clone (18), and to the 94-32 cluster (1065-32 type), respectively, both of which are major Beijing groups found throughout the former Soviet Union (18-23).…”

Mycobacterium tuberculosis Strains of the Modern Sublineage of the Beijing Family Are More Likely To Display Increased Virulence than Strains of the Ancient Sublineage

“…Epidemiological studies evaluating dissemination of different phylogenetic groups of the Beijing M. tuberculosis family in different regions of the world demonstrated that the growing prevalence of Beijing TB is driven by strains of the modern sublineage, not ancient Beijing strains (5,17,18). These observations lead us to speculate that the supposed enhanced virulence and transmissibility, promoting dissemination of the Beijing strains, could be associated predominantly with strains of the modern sublineage.…”

Molecular Epidemiology of Tuberculosis in the Kaliningrad Region of Russia: 10 Years After

“…Напротив, в других странах Европы распространенность штаммов Beijing относительно невелика: Финляндия -5,2%, Швеция -5,8%, Польша -6,5%, причем их источники иные и более разнообразные, включая, в частности, штаммы, занесенные из Восточной Азии [6,11,24]. Известно, что на Северо-Западе России в по-пуляции M. tuberculosis генотипа Beijing широко представлены штаммы кластера В0/W148, ра-нее определенного как успешный российский вариант микобактерий туберкулеза [14]. Этот геновариант был впервые выявлен в середине-конце 1990-х гг.…”

“…Этот геновариант был впервые выявлен в середине-конце 1990-х гг. [4,13,23] и характеризуется зна-чимой ассоциацией с МЛУ и повышенной клас-теризацией (даже при сравнении с другими ва-риантами семейства Beijing) [14]. Была показана высокая способность штаммов B0/W148 к рас-пространению (трансмиссивность), в том числе описан случай нозокомиальной передачи [21].…”

“…Была показана высокая способность штаммов B0/W148 к рас-пространению (трансмиссивность), в том числе описан случай нозокомиальной передачи [21]. В нашем исследовании доля штаммов кластера В0/W148 генотипа Beijing составила 19,2%, что выше, чем в европейской части России и сход-но с ситуацией в Сибири, где доля B0/W148 со-ставляла 20-22% [14]. В то же время при таких сравнениях следует учитывать, что предыдущие исследования проводились в разные годы.…”