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Author(s): Matthew Rudd [sup.1], Woo-Jung Song [sup.2], Peter M. Small [sup.3] Author Affiliations: (1) grid.267628.f, 0000 0001 2149 5776, Department of Mathematics and Computer Science, The University of the South, [...]

Mycobacterium tuberculosis is an obligate human pathogen capable of persisting in individual hosts for decades. We sequenced the genomes of 21 strains representative of the global diversity and six major lineages of the M. tuberculosis complex (MTBC) at 40- to 90-fold coverage using Illumina next-generation DNA sequencing. We constructed a genome-wide phylogeny based on these genome sequences. Comparative analyses of the sequences showed, as expected, that essential genes in MTBC were more evolutionarily conserved than nonessential genes. Notably, however, most of the 491 experimentally confirmed human T cell epitopes showed little sequence variation and had a lower ratio of nonsynonymous to synonymous changes than seen in essential and nonessential genes. We confirmed these findings in an additional data set consisting of 16 antigens in 99 MTBC strains. These findings are consistent with strong purifying selection acting on these epitopes, implying that MTBC might benefit from recognition by human T cells.

Results of a study to evaluate the efficacy of Xpert MTB/RIF, an automated molecular detection test for myobacterium tuberculosis (MTB) and resistance to rifampin (RIF) in patients with suspected drug-sensitive tuberculosis have revealed that the test was highly effective in sensitive detection of tuberculosis and RIF resistance. The situation tends to look optimistic with countries like China, Brazil, India and South Africa showing ability to tackle their own tuberculosis problems, thereby making the goal of elimination of tuberculosis by 2050 a reality.

The Beijing family of Mycobacterium tuberculosis strains has been associated with epidemic spread and an increased likelihood of developing drug resistance. The characteristics that predispose this family to such clinical outcomes have not been identified, although one potential candidate, the phenolic glycolipid PGL-tb, has been shown to mediate a fulminant lethal disease in mice and rabbits due to lipid-mediated immunosuppression. However, PGL-tb is not uniformly expressed throughout the Beijing lineage and may not be the only unique virulence trait associated with this family. In an attempt to define phenotypes common to all Beijing strains, we interrogated a carefully selected set of isolates representing the five extant lineages of the Beijing family. Comparison of lipid production in this set revealed that all Beijing strains accumulated large quantities of triacylglycerides in in vitro aerobic culture. This accumulation was found to be coincident with upregulation of Rv3130c, whose product was previously characterized as a triacylglyceride synthase. Rv3130c is a member of the DosR-controlled regulon of M. tuberculosis, and further examination revealed that several members of this regulon were upregulated throughout this strain family. The upregulation of the DosR regulon may confer an adaptive advantage for growth in microaerophilic or anaerobic environments encountered by the bacillus during infection and thus may be related to the epidemiological phenomena associated with this important strain lineage.

Intraspecies genetic diversity has been demonstrated to be important in the pathogenesis and epidemiology of several pathogens, such as HIV, influenza, Helicobacter and Salmonella. It is also important to consider strain-to-strain variation when identifying drug targets and vaccine antigens and developing tools for molecular diagnostics. Here, the authors present a description of the variability in gene expression patterns among ten clinical isolates of Mycobacterium tuberculosis, plus the laboratory strains H37Rv and H37Ra, growing in liquid culture. They identified 527 genes (15 % of those tested) that are variably expressed among the isolates studied. The remaining genes were divided into three categories based on their expression levels: unexpressed (38 %), low to undetectable expression (31 %) and consistently expressed (16 %). The expression categories were compared with functional categories and three biologically interesting gene lists: genes that are deleted among clinical isolates, T-cell antigens and essential genes. There were significant associations between expression variability and the classification of genes as T-cell antigens, involved in lipid metabolism, PE/PPE, insertion sequences and phages, and deleted among clinical isolates. This survey of mRNA expression among clinical isolates of M. tuberculosis demonstrates that genes with important functions can vary in their expression levels between strains grown under identical conditions. Abbreviations: Ch1, channel1; Ch2, channel 2; CI, confidence interval; SMD, Stanford Microarray Database.

The effect of HIV on tuberculosis (TB) outbreaks and prediction of the effect are discussed with consideration of implications for global control and planned US elimination. A discrete event simulation model was used to predict the potential impact of HIV on increasing the probability and expected severity of TB outbreaks. Predictions showed that an HIV epidemic can significantly increase frequency and severity of TB outbreaks, but that this amplification effect of HIV on outbreaks is very sensitive to the TB treatment rate.

The use of polymerase chain reaction-single-stranded conformational polymorphism (PCR-SSCP) to study rpoB gene mutations in rifampin-resistant (RIFr) Mycobacterium tuberculosis has yielded contradictory results. To determine the sensitivity of this method, [...]

The prevention and treatment of tuberculosis in the US is reviewed. Topics include epidemiology, recommended anti-tuberculosis drugs, HIV patients, tuberculosis in other parts of the body, drug-resistance, tuberculin skin tests and their interpretation.