首页|Inferring Mycobacterium Tuberculosis Drug Resistance and Transmission using Whole-genome Sequencing in a High TB-burden Setting in China

Inferring Mycobacterium Tuberculosis Drug Resistance and Transmission using Whole-genome Sequencing in a High TB-burden Setting in China

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Objective China is among the 30 countries with a high burden of tuberculosis(TB)worldwide,and TB remains a public health concern.Kashgar Prefecture in the southern Xinjiang Autonomous Region is considered as one of the highest TB burden regions in China.However,molecular epidemiological studies of Kashgar are lacking.Methods A population-based retrospective study was conducted using whole-genome sequencing(WGS)to determine the characteristics of drug resistance and the transmission patterns.Results A total of 1,668 isolates collected in 2020 were classified into lineages 2(46.0%),3(27.5%),and 4(26.5%).The drug resistance rates revealed by WGS showed that the top three drugs in terms of the resistance rate were isoniazid(7.4%,124/1,668),streptomycin(6.0%,100/1,668),and rifampicin(3.3%,55/1,668).The rate of rifampicin resistance was 1.8%(23/1,290)in the new cases and 9.4%(32/340)in the previously treated cases.Known resistance mutations were detected more frequently in lineage 2 strains than in lineage 3 or 4 strains,respectively:18.6%vs.8.7 or 9%,P<0.001.The estimated proportion of recent transmissions was 25.9%(432/1,668).Multivariate logistic analyses indicated that sex,age,occupation,lineage,and drug resistance were the risk factors for recent transmission.Despite the low rate of drug resistance,drug-resistant strains had a higher risk of recent transmission than the susceptible strains(adjusted odds ratio,1.414;95%CI,1.023-1.954;P = 0.036).Among all patients with drug-resistant tuberculosis(DR-TB),78.4%(171/218)were attributed to the transmission of DR-TB strains.Conclusion Our results suggest that drug-resistant strains are more transmissible than susceptible strains and that transmission is the major driving force of the current DR-TB epidemic in Kashgar.

Mycobacterium tuberculosisWhole-genome sequencing(WGS)TransmissionDrug resistanceXinjiang

FAN Yu Feng、LIU Dong Xin、CHEN Yi Wang、OU Xi Chao、MAO Qi Zhi、YANG Ting Ting、WANG Xi Jiang、HE Wen Cong、ZHAO Bing、LIU Zhen Jiang、ABULIMITI Maiweilanjiang、AIHEMUTI Maimaitiaili、GAO Qian、ZHAO Yan Lin

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Key Laboratory of Medical Molecular Virology(MOE/NHC/CAMS),School of Basic Medical Sciences,Shanghai Medical College,Fudan University,Shanghai 200032,China

National Tuberculosis Reference Laboratory,Chinese Center for Disease Control and Prevention,Beijing 102206,China

Hangzhou Red Cross Hospital,Hangzhou 310005,Zhejiang,China

Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention,Urumqi 830026,Xinjiang,China

Tuberculosis Dispensary of Kashgar Prefecture,Kashgar 844099,Xinjiang,China

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National Key R&D Program of ChinaNatural Science Foundation of Xinjiang Uygur Autonomous RegionNatural Science Foundation of Xinjiang Uygur Autonomous RegionApplied Technology Research and Development Programing Project of Kashgar PrefectureApplied Technology Research and Development Programing Project of Kashgar Prefecture

2022YFC23052002021A01D1452022D01A115KS2021031KS2021034

2024

10.3967/bes2023.116

生物医学与环境科学(英文版)
中国疾病预防控制中心

生物医学与环境科学(英文版)

CSTPCD
影响因子：0.76
ISSN：0895-3988
年,卷(期)：2024.37(2)
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