Recurrences of multidrug-resistant tuberculosis: Strains involved, within-host diversity, and fine-tuned allocation of reinfections
Por:
Pérez-Lago L, Monteserin J, Paul R, Maus SR, Yokobori N, Herranz M, Sicilia J, Acosta F, Fajardo S, Chiner-Oms Á, Matteo M, Simboli N, Comas I, Muñoz P, López B, Ritacco V and García de Viedma D
Publicada:
1 mar 2022
Ahead of Print:
1 ene 2021
Resumen:
Recurrent tuberculosis occurs due to exogenous reinfection or reactivation/persistence. We analysed 90 sequential MDR Mtb isolates obtained in Argentina from 27 patients with previously diagnosed MDR-TB that recurred in 2018 (1-10 years, 2-10 isolates per patient). Three long-term predominant strains were responsible for 63% of all MDR-TB recurrences. Most of the remaining patients were infected by strains different from each other. Reactivation/persistence of the same strain caused all but one recurrence, which was due to a reinfection with a predominant strain. One of the prevalent strains showed marked stability in the recurrences, while in another strain higher SNP-based diversity was observed. Comparisons of intra- versus inter-patient SNP distances identified two possible reinfections with closely related variants circulating in the community. Our results show a complex scenario of MDR-TB infections in settings with predominant MDR Mtb strains.
Filiaciones:
Pérez-Lago L:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Monteserin J:
Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
Instituto Nacional de Enfermedades Infecciosas ANLIS Carlos G Malbrán, Buenos Aires, Argentina
Paul R:
Instituto Nacional de Enfermedades Infecciosas ANLIS Carlos G Malbrán, Buenos Aires, Argentina
Maus SR:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Yokobori N:
Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
Instituto Nacional de Enfermedades Infecciosas ANLIS Carlos G Malbrán, Buenos Aires, Argentina
Herranz M:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
CIBER Enfermedades respiratorias (CIBERES), Spain
Sicilia J:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Acosta F:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Fajardo S:
Centro Regional de estudios Bioquñimicos de la Tuberculosis, Rosario, Argentina
:
Centro Superior de Investigación en Salud Pública (FISABIO), Universitat de València, Valencia, Spain
Matteo M:
Laboratorio Cetrángolo, Hospital Muñiz/Instituto de Tisioneumonología Raúl Vaccarezza, Universidad de Buenos Aires, Buenos Aires, Argentina
Simboli N:
Instituto Nacional de Enfermedades Infecciosas ANLIS Carlos G Malbrán, Buenos Aires, Argentina
:
Instituto de Biomedicina de Valencia IBV-CSIC, Valencia, Spain
CIBER Salud Pública (CIBERESP), Spain
Muñoz P:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Departamento de Medicina, Universidad Complutense, Madrid, Spain
López B:
Instituto Nacional de Enfermedades Infecciosas ANLIS Carlos G Malbrán, Buenos Aires, Argentina
Ritacco V:
Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
Instituto Nacional de Enfermedades Infecciosas ANLIS Carlos G Malbrán, Buenos Aires, Argentina
García de Viedma D:
Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
CIBER Enfermedades respiratorias (CIBERES), Spain
Green Published, gold
|