Portal de Periódicos da CAPES

Simplified Model to Survey Tuberculosis Transmission in Countries Without Systematic Molecular Epidemiology Programs

2019; Centers for Disease Control and Prevention; Volume: 25; Issue: 3 Linguagem: Inglês

10.3201/eid2503.181593

1080-6059

Juan José Fernández Domínguez, Fermín Acosta, Laura Pérez‐Lago, Dilcia Sambrano, Victoria Batista, Carolina De La Guardia, Estefanía Abascal, Álvaro Chiner‐Oms, Iñaki Comas, Prudencio González, Jaime Bravo, Pedro Del Cid, Samantha Rosas, Patricia Muñóz, Amador Goodridge, Darı́o Garcı́a de Viedma,

Diagnosis and treatment of tuberculosis

Systematic molecular/genomic epidemiology studies for tuberculosis surveillance cannot be implemented in many countries. We selected Panama as a model for an alternative strategy. Mycobacterial interspersed repetitive unit-variable-number tandem-repeat (MIRU-VNTR) analysis revealed a high proportion (50%) of Mycobacterium tuberculosis isolates included in 6 clusters (A-F) in 2 provinces (Panama and Colon). Cluster A corresponded to the Beijing sublineage. Whole-genome sequencing (WGS) differentiated clusters due to active recent transmission, with low single-nucleotide polymorphism-based diversity (cluster C), from clusters involving long-term prevalent strains with higher diversity (clusters A, B). Prospective application in Panama of 3 tailored strain-specific PCRs targeting marker single-nucleotide polymorphisms identified from WGS data revealed that 31.4% of incident cases involved strains A-C and that the Beijing strain was highly represented and restricted mainly to Colon. Rational integration of MIRU-VNTR, WGS, and tailored strain-specific PCRs could be a new model for tuberculosis surveillance in countries without molecular/genomic epidemiology programs.