Distinct clinical and epidemiological features of tuberculosis in New York City caused by the RD^Rio Mycobacterium tuberculosis sublineage

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• 作者：Scott A. Weisenberg^a ; ⁱ ; ¹ ; Andrea L. Gibson^a ; ¹ ; Richard C. Huard^a ; ^d ; Natalia Kurepina^c ; Heejung Bang^b ; Luiz C.O. Lazzarini^a ; ^e ; Yalin Chiu^b ; Jiehui Li^f ; Shama Ahuja^f ; Jeff Driscoll^g ; ^h ; Barry N. Kreiswirth^c ; John L. Ho^a ; ^{millennium.john@gmail.com}
• 关键词：Tuberculosis ; Lineage ; Epidemiology ; Transmission ; RDRio
• 刊名：Infection ; Genetics and Evolution
• 出版年：2012
• 期刊代码：119_15671348
• 类别：med
• 出版时间：June, 2012
• 卷：12
• 期：4
• 页码：664-670
• 文件大小：206 K

摘要

Background

Genetic tracking of Mycobacterium tuberculosis is a cornerstone of tuberculosis (TB) control programs. The RD^Rio M. tuberculosis sublineage was previously associated with TB in Brazil. We investigated 3847 M. tuberculosis isolates and registry data from New York City (NYC) (2001-2005) to: (1) affirm the position of RD^Rio strains within the M. tuberculosis phylogenetic structure, (2) determine its prevalence, and (3) define transmission, demographic, and clinical characteristics associated with RD^Rio TB.

Methods

Isolates classified as RD^Rio or non-RD^Rio M. tuberculosis by multiplex PCR were further classified as clustered (猢? isolates) or unique based primarily upon IS6110-RFLP patterns and lineage-specific cluster proportions were calculated. The secondary case rate of RD^Rio was compared with other prevalent M. tuberculosis lineages. Genotype data were merged with the data from the NYC TB Registry to assess demographic and clinical characteristics.

Results

RD^Rio strains were found to: (1) be restricted to the Latin American-Mediterranean family, (2) cause approximately 8%of TB cases in NYC, and (3) be associated with heightened transmission as shown by: (i) a higher cluster proportion compared to other prevalent lineages, (ii) a higher secondary case rate, and (iii) cases in children. Furthermore, RD^Rio strains were significantly associated with US-born Black or Hispanic race, birth in Latin American and Caribbean countries, and isoniazid resistance.

Conclusions

The RD^Rio genotype is a single M. tuberculosis strain population that is emerging in NYC. The findings suggest that expanded RD^Rio case and exposure identification could be of benefit due to its association with heightened transmission.