1. The value of the continuous genotyping of multi-drug resistant tuberculosis over 20 years in Spain
- Author
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Iglesias, M.J., Ibarz, D., Cebollada, A., Comín, J., Jiménez, M.S., Vázquez, M.C., Samper, S., Cabezas, T., Reyes, A., Ruiz, I., García, P., López, M.D., Cardeñoso, L., de la Calle, I.J., Ruiz, P., Alados, J.C., Román, J., Villa-Real, R., Saavedra, J., Amores, C., Bermúdez, P., Sánchez, M.A., Montiel, N., Bernal, S., Lepe, J.A., Batista, N., Roldán, E., Torres, L., Navarro, C., Chocarro, P., Aldea, M.J., Viñuelas, J., Vitoria, M.A., Palacios, J.J., Villar, H., Prendes, P., Blanco, M., Vázquez, F., Telenti, M., Sánchez, I., Carbo, L., Escobar, S., Ramírez, A., Gallegos, C., Pérez, M.C., Lecuona, M., Díez, O., Copado, R., Campos, I., Cañas, F., Salas, C., Fernández, C., Roíz, M.P., Barba, I., Manrique, E., Carranza, R., Maroto, A.S., González, A., Rodríguez, E., Martino, V., Sánchez, C., Martínez, C., Robles, P., Simarro, E., Romero, C., López, R., Blanco, M.D., Nebreda, T., Rodríguez, J., Fernández, J.M., Álvarez, E., Jaime, M.L., Tejero, M.D., Alberte, A., Oteda, E., Megías, G., Labayru, C., Ibáñez, R., Campos, A., Carrero, P., Villó, J.M., Sans, T., Pujol, I., Clivillé, X., Castellví, J.B., de Batlle, J., Mariscal, D., Prat, C., García, M., Alcalde, F., Gallén, C., Sauca, G., Cuchi, E., Alonso, C., Corcoy, F., Schmidt, G., Tortola, M.T., Garduño, E., Moreno, J.J., Hernández, P., Montes, I., Roman, J., Alonso, P., Rodríguez, A., Barbeyto, L., Fernández, B., Domínguez, D., Villanueva, R., Iglesias, I., Vasallo, F.J., Sevillano, J., Pascual, A., Pérez del Molino, M.L., Ugalde, E., Dopereiro, R., Cuadros, J.A., Pelayo, I., Cacho, J., Cogollos, R., Páez, M., Prieto, S., Fernández, R., López, P., Domingo, D., Millán, R., Bonilla, I., Merino, P., Toro, C., Ruiz, M.J., Menéndez, M., Romero, P., Tato, M., Simón, M., Urmeneta, A., Delgado, A., García, L., Cobos, J., Merino, J., Aznar, E., Piqueras, J., Navarro, M.D., Artero, J.M., Navascués, A., Gil, A., Leiva, J., Elorduy, L., Urra, E., Idígoras, P., Pérez-Trallero, E., Canut, A., Barrios, J.L., Michans, L., Ayarza, R., García, F., Unzaga, M.J., Navarro, M., Gonzalo, N., Martín, C., Gimeno, A., Elia, M., Sabater, S., Rodríguez, J.C., Santos, M., Bosque, M., López, J., Tabernero, E., Galán, M.I., Instituto de Salud Carlos III - ISCIII, and Instituto de Salud Carlos III
- Subjects
Male ,0301 basic medicine ,Genotyping Techniques ,Extensively Drug-Resistant Tuberculosis ,Minisatellite Repeats ,0302 clinical medicine ,Drug Resistance, Multiple, Bacterial ,Tuberculosis, Multidrug-Resistant ,Epidemiology ,Cluster Analysis ,030212 general & internal medicine ,Child ,Phylogeny ,media_common ,Molecular Epidemiology ,Mycobacterium bovis ,Multidisciplinary ,biology ,Multi-drug-resistant tuberculosis ,Age Factors ,Middle Aged ,Phylogenetics ,Exact test ,Child, Preschool ,Population Surveillance ,Infectious diseases ,Medicine ,Female ,Microbial genetics ,Adult ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,Science ,Policy and public health in microbiology ,Article ,Young Adult ,03 medical and health sciences ,medicine ,Humans ,media_common.cataloged_instance ,European union ,Clinical microbiology ,Genotyping ,Respiratory tract diseases ,Molecular epidemiology ,Health care ,Infant, Newborn ,Infant ,Mycobacterium tuberculosis ,medicine.disease ,biology.organism_classification ,030104 developmental biology ,Risk factors ,Spain ,Demography - Abstract
Molecular epidemiology of circulating clinical isolates is crucial to improve prevention strategies. The Spanish Working Group on multidrug resistant tuberculosis (MDR-TB) is a network that monitors the MDR-TB isolates in Spain since 1998. The aim of this study was to present the study of the MDR-TB and extensively drug-resistant tuberculosis (XDR-TB) patterns in Spain using the different recommended genotyping methods over time by a national coordinated system. Based on the proposed genotyping methods in the European Union until 2018, the preservation of one method, MIRU-VNTR, applied to selected clustered strains permitted to maintain our study open for 20 years. The distribution of demographic, clinical and epidemiological characteristics of clustered and non-clustered cases of MDR/XDR tuberculosis with proportion differences as assessed by Pearson's chi-squared or Fisher's exact test was compared. The differences in the quantitative variables using the Student's-t test and the Mann-Whitney U test were evaluated. The results obtained showed a total of 48.4% of the cases grouped in 77 clusters. Younger age groups, having a known TB case contact (10.2% vs 4.7%) and XDR-TB (16.5% vs 1.8%) were significantly associated with clustering. The largest cluster corresponded to a Mycobacterium bovis strain mainly spread during the nineties. A total of 68.4% of the clusters detected were distributed among the different Spanish regions and six clusters involving 104 cases were grouped in 17 and 18 years. Comparison of the genotypes obtained with those European genotypes included in The European Surveillance System (TESSy) showed that 87 cases had become part of 20 European clusters. The continuity of MDR strain genotyping in time has offered a widespread picture of the situation that allows better management of this public health problem. It also shows the advantage of maintaining one genotyping method over time, which allowed the comparison between ancient, present and future samples. The molecular methods applied in this work were supported by the Carlos III Health Institute in the context of two consecutive Grants FIS15/0317 and 18/0336 and JC was awarded a scholarship by the Government of Aragon / European Social Fund, “Building Europe from Aragon”. Sí
- Published
- 2020