1921
image of Trends of Two Epidemic Multidrug-Resistant Strains of Mycobacterium tuberculosis in Argentina Disclosed by Tailored Molecular Strategy
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645
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Abstract

Two strains—M (sublineage 4.1) and Ra (sublineage 4.3)—have long prevailed in Argentina among patients with multidrug-resistant tuberculosis (MDR-TB). Recently, budget constraints have hampered the surveillance of MDR-TB transmission. Based on whole-genome sequence analysis, we used M- and Ra-specific single nucleotide polymorphisms to tailor two multiplex allele-specific PCRs, which we applied to 252 stored isolates (95% of all newly diagnosed MDR-TB cases countrywide), during 2015–2017. Compared with the latest data available (2007–2009), the M strain has receded (80/324 to 20/252, < 0.0001), particularly among cross-border migrants (12/58 to 0/53, = 0.0003) and HIV-infected people (30/97 to 7/74, = 0.0007), but it still accounts for 4/12 new cases of extensively drug-resistant TB. Differently, the Ra strain remained stable in frequency (39/324 to 33/252) and contributed marginally to the extensive drug-resistance load (1/12). Our novel strategy disclosed recent trends of the two major MDR-TB strains, providing meaningful data to allocate control interventions more efficiently.

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/content/journals/10.4269/ajtmh.19-0397
2019-10-14
2019-11-19
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http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.19-0397
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  • Received : 24 May 2019
  • Accepted : 29 Jul 2019
  • Published online : 14 Oct 2019
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