dc.contributor.author |
Sheen Cortavarria, Patricia |
|
dc.contributor.author |
Couvin, David |
|
dc.contributor.author |
Grandjean, Louis |
|
dc.contributor.author |
Zimic-Peralta, Mirko Juan |
|
dc.contributor.author |
Dominguez, Maria |
|
dc.contributor.author |
Luna, Giannina |
|
dc.contributor.author |
Gilman, Robert Hugh |
|
dc.contributor.author |
Rastogi, Nalin |
|
dc.contributor.author |
Moore, David Alexander James |
|
dc.date.accessioned |
2022-01-04T20:31:48Z |
|
dc.date.available |
2022-01-04T20:31:48Z |
|
dc.date.issued |
2013 |
|
dc.identifier.uri |
https://hdl.handle.net/20.500.12866/10680 |
|
dc.description.abstract |
Background: There is limited available data on the strain diversity of M tuberculosis in Peru, though there may be interesting lessons to learn from a setting where multidrug resistant TB has emerged as a major problem despite an apparently well-functioning DOTS control programme. Methods: Spoligotyping was undertaken on 794 strains of M tuberculosis collected between 1999 and 2005 from 553 community-based patients and 241 hospital-based HIV co-infected patients with pulmonary tuberculosis in Lima, Peru. Phylogenetic and epidemiologic analyses permitted identification of clusters and exploration of spoligotype associations with drug resistance. Results: Mean patient age was 31.9 years, 63% were male and 30.4% were known to be HIV+. Rifampicin mono-resistance, isoniazid mono-resistance and multidrug resistance (MDR) were identified in 4.7%, 8.7% and 17.3% of strains respectively. Of 794 strains from 794 patients there were 149 different spoligotypes. Of these there were 27 strains (3.4%) with novel, unique orphan spoligotypes. 498 strains (62.7%) were clustered in the nine most common spoligotypes: 16.4% SIT 50 (clade H3), 12.3% SIT 53 (clade T1), 8.3% SIT 33 (LAM3), 7.4% SIT 42 (LAM9), 5.5% SIT 1 (Beijing), 3.9% SIT 47 (H1), 3.0% SIT 222 (clade unknown), 3.0% SIT1355 (LAM), and 2.8% SIT 92 (X3). Amongst HIV-negative community-based TB patients no associations were seen between drug resistance and specific spoligotypes; in contrast HIV-associated MDRTB, but not isoniazid or rifampicin mono-resistance, was associated with SIT42 and SIT53 strains. Conclusion: Two spoligotypes were associated with MDR particularly amongst patients with HIV. The MDR-HIV association was significantly reduced after controlling for SIT42 and SIT53 status; residual confounding may explain the remaining apparent association. These data are suggestive of a prolonged, clonal, hospital-based outbreak of MDR disease amongst HIV patients but do not support a hypothesis of strain-specific propensity for the acquisition of resistance-conferring mutations. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
Public Library of Science |
|
dc.relation.ispartofseries |
PLoS ONE |
|
dc.rights |
info:eu-repo/semantics/restrictedAccess |
|
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es |
|
dc.subject |
Humans |
en_US |
dc.subject |
Peru |
en_US |
dc.subject |
Directly Observed Therapy |
en_US |
dc.subject |
Antitubercular Agents |
en_US |
dc.subject |
Phylogeny |
en_US |
dc.subject |
Drug Resistance |
en_US |
dc.subject |
Isoniazid |
en_US |
dc.subject |
Mycobacterium tuberculosis |
en_US |
dc.subject |
Rifampin |
en_US |
dc.subject |
Tuberculosis |
en_US |
dc.title |
Genetic Diversity of Mycobacterium tuberculosis in Peru and Exploration of Phylogenetic Associations with Drug Resistance |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.1371/journal.pone.0065873 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#1.06.01 |
|
dc.relation.issn |
1932-6203 |
|