Mycobacterium tuberculosis of the RD
            <sup>Rio</sup>
            Genotype Is the Predominant Cause of Tuberculosis and Associated with Multidrug Resistance in Porto Alegre City, South Brazil

Costa, Elis Regina Dalla; Lazzarini, Luiz Claudio Oliveira; Perizzolo, Paulo Fernado; Díaz, Chyntia Acosta; Spies, Fernanda Sá; Costa, Luciana Scarlazzari; Ribeiro, Alexandre Moretto; Barroco, Caroline; Schuh, Sandra; Pereira, Marcia Aparecida da Silva; Dias, Claudia; Gomes, Harrison Magdinier; Unis, Gisela; Zaha, Arnaldo; Silva, Pedro Eduardo Almeida da; Suffys, Philip Noël; Rossetti, Maria Lúcia Rosa

doi:10.1128/jcm.01511-12

Cited by 36 publications

(29 citation statements)

References 36 publications

(48 reference statements)

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“…According Pettit et al the higher rate of reinfection among HIV infected patients may be related to increase in exposure in high incidence areas and subsequent increased risk for disease progression [22]. The high number of recurrence in our study and the time between episodes suggest reinfection playing most of the cases as it is expected in a high burden area [1],[4],[7],[9], with a high strain diversity circulating [14]–[16]. …”

Section: Discussionmentioning

confidence: 82%

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Tuberculosis recurrence in a high incidence setting for HIV and tuberculosis in Brazil

Unis¹,

Ribeiro

Esteves

et al. 2014

BMC Infect Dis

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BackgroundTo compare epidemiological data between recurrent cases after cure (RC), distinguishing relapse from reinfection, after dropout (RD) and new cases (NC) in an ambulatory setting in a TB-endemic country.MethodsRecords of patients who started treatment for pulmonary TB between 2004 and 2010 in a TB clinic were reviewed. Epidemiological data were analyzed. Spoligotyping and MIRU patterns were used to determine relapse or reinfection in 13 RC available.ResultsOf the eligible group (1449), 1060 were NC (73.2%), among the recurrent cases, 203 (14%) were RC and 186 (12.8%) were RD. Of RC, 171 (84.2%) occurred later than 6 months after a previous episode, 13 had available DNA, in 4 (30.7%) the disease was attributed to reinfection and in 9 (69.3%), to relapse. Comparing RC to NC, HIV (p < 0.0001) was independent risk factor for RC. When RC and RD were compared, alcohol abuse (p = 0.001) and treatment noncompliance (p = 0.006) were more frequent in RD.ConclusionsHIV is the sole more important associated factor for RC. This finding points the need to improve the approach to manage TB in order to decrease the chance for exposure especially in vulnerable people with increased risk of developing disease and to improve DOTS strategy to deal with factors associated to treatment noncompliance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-014-0548-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 82%

“…The T family, the second most common family, is also, a very common profile causing TB disease in the South Brazil [14]–[16]. The study had no correlation among spoligopatterns families and resistance profile.…”

Section: Discussionmentioning

confidence: 97%

Tuberculosis recurrence in a high incidence setting for HIV and tuberculosis in Brazil

Unis¹,

Ribeiro

Esteves

et al. 2014

BMC Infect Dis

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“…), rare stranger. While the LAM-RUS branch was studied only by one Russian group, the RD-Rio sublineage has attracted much more attention since its discovery (5)(6)(7)29), but evidence of its increased virulence and transmissibility appears controversial (30,31). In this study, only a few isolates belonged to RD-Rio (7 such isolates) (Fig.…”

Section: Figmentioning

confidence: 81%

Mycobacterium tuberculosis Latin American-Mediterranean Family and Its Sublineages in the Light of Robust Evolutionary Markers

2014

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Mycobacterium tuberculosis has a clonal population structure, and the Latin American-Mediterranean (LAM) family is one of the largest and most widespread within this species, showing evidence for remarkable pathobiology and a confusing phylogeny. Here, we applied robust phylogenetic markers to study the evolution of the LAM family and its major sublineages circulating in Russia and neighboring countries. A total of 250 M. tuberculosis isolates were confirmed to belong to the LAM family based on the analysis of the LAM-specific single-nucleotide polymorphisms (SNPs) in the Rv3062 and Rv0129c genes. At this stage, the family status was rectified for 121 isolates misleadingly assigned by CRISPR spoligotyping to non-LAM families (T1-or T5-RUS1). Consequently, the reestimated LAM prevalence rate increased 2-fold in Russia and Kazakhstan and 4-fold in Belarus. The majority (91.8 to 98.7%) of the LAM isolates from all three countries belonged to the LAM-RUS sublineage. In contrast, the Ibero-American LAM RD-Rio sublineage was identified in only 7 Russian isolates. Taken together, our findings and further analyses suggest a monophyletic origin of LAM-RUS: at a historically distant time, in Russia, in a small founding bacterial/human population. Its dissemination pattern and high prevalence rate in Northern Eurasia may indicate a long-term coexistence of the LAM-RUS sublineage and local human populations hypothetically leading to coadaptation and reduced pathogenicity of the relatively more ancient clones, such as spoligotype international type 254 (SIT254), compared to the more recent SIT252 and SIT266 clones. In contrast, rare LAM RD-Rio isolates were likely brought to Russia through occasional human contact. The spread of RD-Rio strains is not as global as commonly claimed and is determined largely by human migration flows (rather than by pathobiological properties of these strains). Consequently, a host population factor appears to play a major role in shaping the in situ dissemination pattern of the imported strains in an autochthonous population.Nothing in biology makes sense except in the light of evolution.-Theodosius Dobzhansky (32) M ycobacterium tuberculosis is doubtless an important pathogen from a human health viewpoint. Per se, it is also an interesting biological species. Under the umbrella name M. tuberculosis complex, it encompasses different ecotypes, its niches expanding well beyond that of the human host. It has long been a common yet true saying that M. tuberculosis is marked by a high level of genetic homogeneity (1). Over the past decade, an expansion of knowledge, greatly aided by whole-genome sequencing, has demonstrated a higher level of genetic variation than initially thought. On the other hand, notwithstanding the excellent added value of new-generation technologies, the previous use of the much simpler molecular typing methods more than 10 years ago delineated the phylogenetic structure of M. tuberculosis and identified most of its major families/genotypes (2). A Latin AmericanMediterranean ...

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“…These strains have a deletion of 26.3 kb and seem to be restricted to the Latin American-Mediterranean (LAM) family. The RD Rio strains have been associated with higher levels of recent transmission and of Multi-Drug Resistance (MDR) but there are contradictory data about their relation with disease severity [3] , [4] , [5] , [6] . Another Region of Difference called RD174 has been described as a co-marker of RD Rio and as a marker for the LAM type [7] , [8] , [9] , [10] and strains with the RD174 deletion were found to have an increased secondary case rate ratio in San Francisco [10] .…”

Section: Introductionmentioning

confidence: 99%

Strain Classification of Mycobacterium tuberculosis Isolates in Brazil Based on Genotypes Obtained by Spoligotyping, Mycobacterial Interspersed Repetitive Unit Typing and the Presence of Large Sequence and Single Nucleotide Polymorphism

et al. 2014

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Rio de Janeiro is endemic for tuberculosis (TB) and presents the second largest prevalence of the disease in Brazil. Here, we present the bacterial population structure of 218 isolates of Mycobacterium tuberculosis, derived from 186 patients that were diagnosed between January 2008 and December 2009. Genotypes were generated by means of spoligotyping, 24 MIRU-VNTR typing and presence of fbpC103, RDRio and RD174. The results confirmed earlier data that predominant genotypes in Rio de Janeiro are those of the Euro American Lineages (99%). However, we observed differences between the classification by spoligotyping when comparing to that of 24 MIRU-VNTR typing, being respectively 43.6% vs. 62.4% of LAM, 34.9% vs. 9.6% of T and 18.3% vs. 21.5% of Haarlem. Among isolates classified as LAM by MIRU typing, 28.0% did not present the characteristic spoligotype profile with absence of spacers 21 to 24 and 32 to 36 and we designated these conveniently as “LAM-like”, 79.3% of these presenting the LAM-specific SNP fbpC103. The frequency of RDRio and RD174 in the LAM strains, as defined both by spoligotyping and 24 MIRU-VNTR loci, were respectively 11% and 15.4%, demonstrating that RD174 is not always a marker for LAM/RDRio strains. We conclude that, although spoligotyping alone is a tool for classification of strains of the Euro-American lineage, when combined with MIRU-VNTRs, SNPs and RD typing, it leads to a much better understanding of the bacterial population structure and phylogenetic relationships among strains of M. tuberculosis in regions with high incidence of TB.

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Mycobacterium tuberculosis of the RD ^Rio Genotype Is the Predominant Cause of Tuberculosis and Associated with Multidrug Resistance in Porto Alegre City, South Brazil

Cited by 36 publications

References 36 publications

Tuberculosis recurrence in a high incidence setting for HIV and tuberculosis in Brazil

Tuberculosis recurrence in a high incidence setting for HIV and tuberculosis in Brazil

Mycobacterium tuberculosis Latin American-Mediterranean Family and Its Sublineages in the Light of Robust Evolutionary Markers

Strain Classification of Mycobacterium tuberculosis Isolates in Brazil Based on Genotypes Obtained by Spoligotyping, Mycobacterial Interspersed Repetitive Unit Typing and the Presence of Large Sequence and Single Nucleotide Polymorphism

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Mycobacterium tuberculosis of the RD Rio Genotype Is the Predominant Cause of Tuberculosis and Associated with Multidrug Resistance in Porto Alegre City, South Brazil

Cited by 36 publications

References 36 publications

Tuberculosis recurrence in a high incidence setting for HIV and tuberculosis in Brazil

Tuberculosis recurrence in a high incidence setting for HIV and tuberculosis in Brazil

Mycobacterium tuberculosis Latin American-Mediterranean Family and Its Sublineages in the Light of Robust Evolutionary Markers

Strain Classification of Mycobacterium tuberculosis Isolates in Brazil Based on Genotypes Obtained by Spoligotyping, Mycobacterial Interspersed Repetitive Unit Typing and the Presence of Large Sequence and Single Nucleotide Polymorphism

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Mycobacterium tuberculosis of the RD ^Rio Genotype Is the Predominant Cause of Tuberculosis and Associated with Multidrug Resistance in Porto Alegre City, South Brazil