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Molecular epidemiology of multi- and extensively-drug-resistant Mycobacterium tuberculosis in Ireland, 2001-2014


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, 76, (1) pp. 55-67. ISSN 0163-4453 (2018) [Refereed Article]

Copyright Statement

2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

DOI: doi:10.1016/j.jinf.2017.10.002


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 Details

Item Type:Refereed Article
Keywords:tuberculosis, molecular epidemiology, drug resistance
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Infectious diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:O'Toole, RF (Dr Ronan O'Toole)
ID Code:121865
Year Published:2018 (online first 2017)
Web of Science® Times Cited:11
Deposited By:Medicine
Deposited On:2017-10-18
Last Modified:2018-04-18

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