MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER

In the Kaliningrad region, the incidence of tuberculosis (TB) has declined significantly over the past decade (from 134/100 000 in 2006 to 50.6/100 000 in 2015), but still exceeds the average for the North-West Russia (40.7/100 000). In view of the increase in the proportion of primary multidrug res...

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Autores principales:	A. A. Vyazovaya, G. M. Akhmedova, N. S. Solovieva, A. A. Gerasimova, D. A. Starkova, E. N. Turkin, V. Yu. Zhuravlev, O. V. Narvskaya, I. V. Mokrousov
Formato:	article
Lenguaje:	RU
Publicado:	Sankt-Peterburg : NIIÈM imeni Pastera 2018
Materias:	pulmonary tuberculosis molecular epidemiology kaliningrad region mycobacterium tuberculosis drug resistance spoligotyping beijing genotype Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/54dfc13d55144883b39a9ce7a21b3a86
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spelling	oai:doaj.org-article:54dfc13d55144883b39a9ce7a21b3a862021-11-22T07:09:48ZMOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER2220-76192313-739810.15789/2220-7619-2017-4-367-374https://doaj.org/article/54dfc13d55144883b39a9ce7a21b3a862018-01-01T00:00:00Zhttps://www.iimmun.ru/iimm/article/view/594https://doaj.org/toc/2220-7619https://doaj.org/toc/2313-7398In the Kaliningrad region, the incidence of tuberculosis (TB) has declined significantly over the past decade (from 134/100 000 in 2006 to 50.6/100 000 in 2015), but still exceeds the average for the North-West Russia (40.7/100 000). In view of the increase in the proportion of primary multidrug resistance (MDR) of the causative agent from 23.9% in 2010 to 30.5% in 2015, the aim of this study was to analyze the current Mycobacterium tuberculosis population structure in the Kaliningrad region and to evaluate its spatial-temporal trends. The 73 M. tuberculosis isolates from patients with pulmonary TB newly diagnosed in 2015 were studied. Drug resistance (DR) was detected in 46 (63.0%) M. tuberculosis strains; of these, 32 (43.8%) were multidrug-resistant (MDR). The 46 (63.0%) of 73 M. tuberculosis strains were of the Beijing genotype with 19.2% (14 out of 73) share of the B0/W148 cluster. Spoligotyping of 27 non-Beijing M. tuberculosis strains made it possible to identify 15 spoligotypes of 5 genetic families — T, LAM, Ural, S, X. About half (16; 51.6%) of non-Beijing strains were represented by spoligotypes — SIT42, SIT53, SIT262, and SIT444. In a heterogeneous group T, mostly drugsusceptible strains of spoligotype SIT53 were prevailing. More than half (55.6%) of the LAM genotype strains exhibited DR. The Ural family was small (5.5%) and included strains of well-known in Russia M. tuberculosis spoligotypes SIT35 and SIT262, and one new, not found previously. MDR was statistically significantly associated with the Beijing genotype: 56.5% versus 25.9% in strains of other genotypes (in total) (P = 0.0134). Moreover, all 14 strains of epidemiologically and clinically significant B0/W148 cluster were MDR. The proportion of MDR strains of the Beijing genotype did not change significantly: in 2006 it was 61.3%, in 2015 — 56.5% (P = 0.6773). However, the spectrum of drug resistance to first-line anti-TB drugs expanded. If previously the majority (78.9%) of MDR strains additionally exhibited resistance to streptomycin only, in present study 72.0% of MDR strains were resistant to streptomycin, ethambutol, and pyrazinamide. The proportion of MDR strains of non-Beijing genotypes was 25.9%, a significantly higher than the similar indicators in 2006 — 2.2% (P = 0.0124). A relatively smaller proportion of strains of the Beijing genotype (50%) was found in TB patients from the shores of the Baltic Sea, a territory with a relatively more favorable socio-economic situation and a higher standard of living. Thus, the current epidemiological situation of TB in the Kaliningrad region is crucially determined by the growing circulation of MDR Beijing family strains, as well as a significant increase in the proportion of MDR strains of other genotypes.A. A. VyazovayaG. M. AkhmedovaN. S. SolovievaA. A. GerasimovaD. A. StarkovaE. N. TurkinV. Yu. ZhuravlevO. V. NarvskayaI. V. MokrousovSankt-Peterburg : NIIÈM imeni Pasteraarticlepulmonary tuberculosismolecular epidemiologykaliningrad regionmycobacterium tuberculosisdrug resistancespoligotypingbeijing genotypeInfectious and parasitic diseasesRC109-216RUInfekciâ i Immunitet, Vol 7, Iss 4, Pp 367-374 (2018)
institution	DOAJ
collection	DOAJ
language	RU
topic	pulmonary tuberculosis molecular epidemiology kaliningrad region mycobacterium tuberculosis drug resistance spoligotyping beijing genotype Infectious and parasitic diseases RC109-216
spellingShingle	pulmonary tuberculosis molecular epidemiology kaliningrad region mycobacterium tuberculosis drug resistance spoligotyping beijing genotype Infectious and parasitic diseases RC109-216 A. A. Vyazovaya G. M. Akhmedova N. S. Solovieva A. A. Gerasimova D. A. Starkova E. N. Turkin V. Yu. Zhuravlev O. V. Narvskaya I. V. Mokrousov MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER
description	In the Kaliningrad region, the incidence of tuberculosis (TB) has declined significantly over the past decade (from 134/100 000 in 2006 to 50.6/100 000 in 2015), but still exceeds the average for the North-West Russia (40.7/100 000). In view of the increase in the proportion of primary multidrug resistance (MDR) of the causative agent from 23.9% in 2010 to 30.5% in 2015, the aim of this study was to analyze the current Mycobacterium tuberculosis population structure in the Kaliningrad region and to evaluate its spatial-temporal trends. The 73 M. tuberculosis isolates from patients with pulmonary TB newly diagnosed in 2015 were studied. Drug resistance (DR) was detected in 46 (63.0%) M. tuberculosis strains; of these, 32 (43.8%) were multidrug-resistant (MDR). The 46 (63.0%) of 73 M. tuberculosis strains were of the Beijing genotype with 19.2% (14 out of 73) share of the B0/W148 cluster. Spoligotyping of 27 non-Beijing M. tuberculosis strains made it possible to identify 15 spoligotypes of 5 genetic families — T, LAM, Ural, S, X. About half (16; 51.6%) of non-Beijing strains were represented by spoligotypes — SIT42, SIT53, SIT262, and SIT444. In a heterogeneous group T, mostly drugsusceptible strains of spoligotype SIT53 were prevailing. More than half (55.6%) of the LAM genotype strains exhibited DR. The Ural family was small (5.5%) and included strains of well-known in Russia M. tuberculosis spoligotypes SIT35 and SIT262, and one new, not found previously. MDR was statistically significantly associated with the Beijing genotype: 56.5% versus 25.9% in strains of other genotypes (in total) (P = 0.0134). Moreover, all 14 strains of epidemiologically and clinically significant B0/W148 cluster were MDR. The proportion of MDR strains of the Beijing genotype did not change significantly: in 2006 it was 61.3%, in 2015 — 56.5% (P = 0.6773). However, the spectrum of drug resistance to first-line anti-TB drugs expanded. If previously the majority (78.9%) of MDR strains additionally exhibited resistance to streptomycin only, in present study 72.0% of MDR strains were resistant to streptomycin, ethambutol, and pyrazinamide. The proportion of MDR strains of non-Beijing genotypes was 25.9%, a significantly higher than the similar indicators in 2006 — 2.2% (P = 0.0124). A relatively smaller proportion of strains of the Beijing genotype (50%) was found in TB patients from the shores of the Baltic Sea, a territory with a relatively more favorable socio-economic situation and a higher standard of living. Thus, the current epidemiological situation of TB in the Kaliningrad region is crucially determined by the growing circulation of MDR Beijing family strains, as well as a significant increase in the proportion of MDR strains of other genotypes.
format	article
author	A. A. Vyazovaya G. M. Akhmedova N. S. Solovieva A. A. Gerasimova D. A. Starkova E. N. Turkin V. Yu. Zhuravlev O. V. Narvskaya I. V. Mokrousov
author_facet	A. A. Vyazovaya G. M. Akhmedova N. S. Solovieva A. A. Gerasimova D. A. Starkova E. N. Turkin V. Yu. Zhuravlev O. V. Narvskaya I. V. Mokrousov
author_sort	A. A. Vyazovaya
title	MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER
title_short	MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER
title_full	MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER
title_fullStr	MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER
title_full_unstemmed	MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER
title_sort	molecular epidemiology of tuberculosis in the kaliningrad region of russia: 10 years after
publisher	Sankt-Peterburg : NIIÈM imeni Pastera
publishDate	2018
url	https://doaj.org/article/54dfc13d55144883b39a9ce7a21b3a86
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MOLECULAR EPIDEMIOLOGY OF TUBERCULOSIS IN THE KALININGRAD REGION OF RUSSIA: 10 YEARS AFTER

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