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Title: Systematic survey of clonal complexity in tuberculosis at a populational level and detailed characterization of the isolates involved.
Authors: Navarro, Yurena
Herranz, Marta
Pérez-Lago, Laura
Martínez Lirola, Miguel
Ruiz-Serrano, Maria Jesús
Bouza, Emilio
García de Viedma, Darío
metadata.dc.contributor.authoraffiliation: [Navarro,Y; Herranz, M; Ruiz-Serrano,MJ; Bouza,E; García de Viedma,D] Servicio de Microbiología y Enfermedades Infecciosas, Hospital Gregorio Marañón, Madrid, Spain. [Navarro,Y; Herranz, M; Ruiz-Serrano,MJ; Bouza,E; García de Viedma,D] CIBER Enfermedades Respiratorias-CIBERES, Spain. [Pérez-Lago,L.] Servicio de Microbiología y Enfermedades Infecciosas, Hospital Gregorio Marañón, Madrid, Spain. [Martínez Lirola,M] Complejo Hospitalario Torrecárdenas, Almería, Spain.
Keywords: Antígenos Bacterianos;Hidrolasas de Éster Carboxílico;Elementos Transponibles de ADN;ADN Bacteriano;Genotipo;Tipificación Molecular;Mycobacterium tuberculosis;Polimorfismo de Longitud del Fragmento de Restricción;Tuberculosis
metadata.dc.subject.mesh: Medical Subject Headings::Chemicals and Drugs::Enzymes and Coenzymes::Enzymes::Hydrolases::Esterases::Carboxylic Ester Hydrolases
Medical Subject Headings::Diseases::Virus Diseases::Coinfection
Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Genetic Structures::Genome::Genome Components::Interspersed Repetitive Sequences::DNA Transposable Elements
Medical Subject Headings::Chemicals and Drugs::Nucleic Acids, Nucleotides, and Nucleosides::Nucleic Acids::DNA::DNA, Bacterial
Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Genotype
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Genetic Techniques::Molecular Typing
Medical Subject Headings::Organisms::Bacteria::Gram-Positive Bacteria::Gram-Positive Rods::Gram-Positive Asporogenous Rods::Gram-Positive Asporogenous Rods, Regular::Mycobacteriaceae::Mycobacterium::Mycobacterium tuberculosis
Medical Subject Headings::Phenomena and Processes::Genetic Phenomena::Genetic Variation::Polymorphism, Genetic::Polymorphism, Restriction Fragment Length
Medical Subject Headings::Health Care::Environment and Public Health::Public Health::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Prevalence
Medical Subject Headings::Diseases::Bacterial Infections and Mycoses::Bacterial Infections::Gram-Positive Bacterial Infections::Actinomycetales Infections::Mycobacterium Infections::Tuberculosis
Medical Subject Headings::Chemicals and Drugs::Biological Factors::Antigens::Antigens, Bacterial
Issue Date: 28-Dec-2011
Publisher: American Society for Microbiology
Citation: Navarro Y, Herranz M, Pérez-Lago L, Martínez Lirola M, Ruiz-Serrano MJ, Bouza E, et al. Systematic survey of clonal complexity in tuberculosis at a populational level and detailed characterization of the isolates involved. J. Clin. Microbiol.. 2011; 49(12):4131-7
Abstract: Clonally complex infections by Mycobacterium tuberculosis are progressively more accepted. Studies of their dimension in epidemiological scenarios where the infective pressure is not high are scarce. Our study systematically searched for clonally complex infections (mixed infections by more than one strain and simultaneous presence of clonal variants) by applying mycobacterial interspersed repetitive-unit (MIRU)-variable-number tandem-repeat (VNTR) analysis to M. tuberculosis isolates from two population-based samples of respiratory (703 cases) and respiratory-extrapulmonary (R+E) tuberculosis (TB) cases (71 cases) in a context of moderate TB incidence. Clonally complex infections were found in 11 (1.6%) of the respiratory TB cases and in 10 (14.1%) of those with R+E TB. Among the 21 cases with clonally complex TB, 9 were infected by 2 independent strains and the remaining 12 showed the simultaneous presence of 2 to 3 clonal variants. For the 10 R+E TB cases with clonally complex infections, compartmentalization (different compositions of strains/clonal variants in independent infected sites) was found in 9 of them. All the strains/clonal variants were also genotyped by IS6110-based restriction fragment length polymorphism analysis, which split two MIRU-defined clonal variants, although in general, it showed a lower discriminatory power to identify the clonal heterogeneity revealed by MIRU-VNTR analysis. The comparative analysis of IS6110 insertion sites between coinfecting clonal variants showed differences in the genes coding for a cutinase, a PPE family protein, and two conserved hypothetical proteins. Diagnostic delay, existence of previous TB, risk for overexposure, and clustered/orphan status of the involved strains were analyzed to propose possible explanations for the cases with clonally complex infections. Our study characterizes in detail all the clonally complex infections by M. tuberculosis found in a systematic survey and contributes to the characterization that these phenomena can be found to an extent higher than expected, even in an unselected population-based sample lacking high infective pressure.
metadata.dc.identifier.doi: 10.1128/JCM.05203-11
ISSN: 1098-660X (Online)
0095-1137 (Print)
Appears in Collections:01- Artículos - Complejo Hospitalario Torrecárdenas

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