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The value of the continuous genotyping of multi-drug resistant tuberculosis over 20 years in Spain

2020; Nature Portfolio; Volume: 10; Issue: 1 Linguagem: Inglês

10.1038/s41598-020-77249-x

2045-2322

María José Iglesias, Daniel Ibarz, Alberto Cebollada, Jéssica Comín, María Soledad Jiménez, Cristina Vázquez, Sofía Samper, Teresa Cabezas, A. Reyes, Isabel Ruiz‐Camps, P. Lázaro, Manuel Castillejos‐López, Laura Cardeñoso, I. Jesús de la Calle, P. Ruiz, Juan Carlos Alados, Jesús Pozo, R. Villa-Real, J. Saavedra, Carmen Amores-Antequera, P. Bermúdez, María Antonia Huertas Sánchez, Natalia Montiel, Samuel Bernal, José Antonio Lepe, N. Batista, Édgar Roldán, L. Torres, C. Navarro, P. Chocarro, M. J. Aldea, Jesús Viñuelas, María Asunción Vitoria, Juan J. Palacios, Henar Villar, P. Prendes, M. T. Blanco, F. Parras Vazquez, Mauricio Telenti, I. Prieto Sánchez, Lázaro Carbó, S. Escobar, Alfredo Ramı́rez, Carmen Gallegos, M. C. Pérez, María Lecuona, Olga Celadilla Díez, Rodolfo Copado, Izabella Maria Ferreira Campos, F. Cañas, Carlos E. Salas, Christine Cheryl Fernandez, María Pía Roiz Mesones, I. Barba, Edna Joana Cláudio Manrique, R. Carranza, A. Sánchez Maroto, Arnoldo José González Suárez, E. Rodríguez, Vincent Di Martino, Sánchez González, Carlos Martínez Martínez, Pablo Hernando Robles, E. Simarro, Candice Romero, Rubén López, M. D. Blanco, Teresa Nebreda-Mayoral, Juan Carlos Rodrı́guez, Juan M. Fernández, E. Álvarez, M. L. Jaime, M. D. Tejero, A Alberte, E. Oteda, Gregoria Megías, Cristina Labayru, R. Ibáñez, Ana Rosa Plascencia Campos, Pablo Carrero, J. M. Villó, Teresa Sans, Isabel Pujol, X. Clivillé, J. B. Castellví, Jordi de Batlle, D. Mariscal, Cristina Prat, Marta Domínguez García, Fray Antonio Alcalde, Courtney L. Gallen, Goretti Sauca, E. Cuchí, C. Alonso, F. Corcoy, Grace Schmidt, Teresa Tórtola, E. Garduño, Juan J. Moreno, Pilar Hernández, Isabel Montes, Jesús Pozo, Pedro L. Alonso, A. Rodríguez, L. Barbeyto, B. Fernández, D. Domínguez, Rodrigo A. Villanueva, Irene Iglesias Peinado, Francisco J. Vasallo, José Antonio Sevillano, Álvaro Pascual, Marta Domínguez García, María de Toro, Vincent Di Martino, E. Ugalde, R. Dopereiro, Julio A. Cuadros, I. Pelayo, J. Cacho, R Cogollos, Malvina Páez, Susana Prieto, Rafael Fernández Atuan, Patricio Lopez-Exposito, D. Domingo, Rosario San Millàn, I. Bonilla, Paloma Merino, Carlos Toro, María José Castelló Ruiz, M. Menéndez, P. Romero, Marta Tato, Miguel Ángel Simón, A. Urmeneta, A. Delgado, Luz García, José Pérez de los Cobos, J. Merino, Elena Guadalupe Corella Aznar, J. Fernández Piqueras, Mercedes Navarro, J. M. Artero, Ana Navascués, Ana I. Gil, J. Leiva, L. Elorduy, E Urra, Pedro Idígoras, Emilio Pérez‐Trallero, Andrés Canut, José Luís González Barrios, L. Michans, R. Ayarza, F. García, M.J. Unzaga, Mercedes Navarro, Nieves Gonzalo, Carlos Martı́n, Carlos Martínez Gil, Alberto Gimeno, Manuela Elía-Guedea, Patricio Lopez-Exposito, S. Sabater, Juan Carlos Rodrı́guez, Marlene Santos, Montserrat Bosque, J. A. López, Eva Tabernero, ME Alfonso Galán,

Infectious Diseases and Tuberculosis

Abstract Molecular epidemiology of circulating clinical isolates is crucial to improve prevention strategies. The Spanish Working Group on multidrug resistant tuberculosis (MDR-TB) is a network that monitors the MDR-TB isolates in Spain since 1998. The aim of this study was to present the study of the MDR-TB and extensively drug-resistant tuberculosis (XDR-TB) patterns in Spain using the different recommended genotyping methods over time by a national coordinated system. Based on the proposed genotyping methods in the European Union until 2018, the preservation of one method, MIRU-VNTR, applied to selected clustered strains permitted to maintain our study open for 20 years. The distribution of demographic, clinical and epidemiological characteristics of clustered and non-clustered cases of MDR/XDR tuberculosis with proportion differences as assessed by Pearson’s chi-squared or Fisher’s exact test was compared. The differences in the quantitative variables using the Student's-t test and the Mann–Whitney U test were evaluated. The results obtained showed a total of 48.4% of the cases grouped in 77 clusters. Younger age groups, having a known TB case contact (10.2% vs 4.7%) and XDR-TB (16.5% vs 1.8%) were significantly associated with clustering. The largest cluster corresponded to a Mycobacterium bovis strain mainly spread during the nineties. A total of 68.4% of the clusters detected were distributed among the different Spanish regions and six clusters involving 104 cases were grouped in 17 and 18 years. Comparison of the genotypes obtained with those European genotypes included in The European Surveillance System (TESSy) showed that 87 cases had become part of 20 European clusters. The continuity of MDR strain genotyping in time has offered a widespread picture of the situation that allows better management of this public health problem. It also shows the advantage of maintaining one genotyping method over time, which allowed the comparison between ancient, present and future samples.