Roycroft, E and O'Toole, RF and Fitzgibbon, MM and Montogmery, L and O'Meara, M and Downes, P and Jackson, S and O'Donnell, J and Laurenson, IF and McLaughlin, AM and Keane, J and Rogers, TR, Molecular epidemiology of multi- and extensively-drug-resistant Mycobacterium tuberculosis in ireland, 2001-2014, Journal of Infection ISSN 0163-4453 (2017) [Refereed Article]
Objectives: The primary objective of this work was to examine the acquisition and spread of multi-drug resistant (MDR) tuberculosis (TB) in Ireland.
Methods: All available Mycobacterium tuberculosis complex (MTBC) isolates (n=42), from MDR-TB cases diagnosed in Ireland between 2001 and 2014, were analysed using phenotypic drug-susceptibility testing, Mycobacterial-Interspersed-Repetitive-Units Variable-Number Tandem-Repeat (MIRU-VNTR) genotyping, and whole-genome sequencing (WGS).
Results: The lineage distribution of the MDR-TB isolates comprised 54.7% Euro-American, 33.3% East Asian, 7.2% East African Indian, and 4.8% Indo-Oceanic. A significant association was identified between the East Asian Beijing sub-lineage and the relative risk of an isolate being MDR. Over 75% of MDR-TB cases were confirmed in non-Irish born individuals and 7 MIRU-VNTR genotypes were identical to clusters in other European countries indicating cross-border spread of MDR-TB to Ireland. WGS data provided the first evidence in Ireland of in vivo microevolution of MTBC isolates from drug-susceptible to MDR, and from MDR to extensively-drug resistant (XDR). In addition, they found that the katG S315T isoniazid and rpoB S450L rifampicin resistance mutations were dominant across the different MTBC lineages.
Conclusions: Our molecular epidemiological analyses identified the spread of MDR-TB to Ireland from other jurisdictions and its potential to evolve to XDR-TB.
|Item Type:||Refereed Article|
|Keywords:||tuberculosis, molecular, epidemiology, drug resistance|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Research Field:||Infectious Diseases|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Infectious Diseases|
|Author:||O'Toole, RF (Dr Ronan O'Toole)|
|Deposited By:||Medicine (Discipline)|
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