Long-term dominance of Mycobacterium tuberculosis Uganda family in peri-urban Kampala-Uganda is not associated with cavitary disease

BMC Infectious Diseases

Moses L Joloba⁴  Sebastien Gagneux⁷  Henry W Boom¹  Gilla Kaplan⁵  Kathleen Eisenach⁶  Harriet Mayanja⁴  Mary Nsereko⁴  Benon B Asiimwe³  Sara M Debanne⁸  Ezekiel Mupere⁴  Eddie M Wampande² 

[1] Tuberculosis Research Unit, School of Medicine, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, OH, USA;Department of Bio-molecular Resources and Biolab Sciences, College of Veterinary Medicine, Animal Resources and Bio Security, Makerere University, Kampala, Uganda;Department of Medical Microbiology, College of Health Sciences, Makerere University, Kampala, Uganda;Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda;Laboratory of Mycobacterial Immunity and Pathogenesis, Public Health Research Institute, University of Medicine and Dentistry, Newark, NJ, USA;Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA;University of Basel, Basel, Switzerland;Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, OH, USA

关键词: Evolution;    Epidemiology;    Virulence;    Cavitation;    Strain family;    Mycobacteria;    Single nucleotide polymorphism;    Lineage;    Mycobacterium tuberculosis complex;   

Others  :  1145689
DOI  :  10.1186/1471-2334-13-484

 received in 2013-06-07, accepted in 2013-10-07,  发布年份 2013

【 摘 要 】

Background

Previous studies have shown that Mycobacterium tuberculosis (MTB) Uganda family, a sub-lineage of the MTB Lineage 4, is the main cause of tuberculosis (TB) in Uganda. Using a well characterized patient population, this study sought to determine whether there are clinical and patient characteristics associated with the success of the MTB Uganda family in Kampala.

Methods

A total of 1,746 MTB clinical isolates collected from1992-2009 in a household contact study were genotyped. Genotyping was performed using Single Nucleotide Polymorphic (SNP) markers specific for the MTB Uganda family, other Lineage 4 strains, and Lineage 3, respectively. Out of 1,746 isolates, 1,213 were from patients with detailed clinical data. These data were used to seek associations between MTB lineage/sub-lineage and patient phenotypes.

Results

Three MTB lineages were found to dominate the MTB population in Kampala during the last two decades. Overall, MTB Uganda accounted for 63% (1,092/1,746) of all cases, followed by other Lineage 4 strains accounting for 22% (394/1,746), and Lineage 3 for 11% (187/1,746) of cases, respectively. Seventy-three (4 %) strains remained unclassified. Our longitudinal data showed that MTB Uganda family occurred at the highest frequency during the whole study period, followed by other Lineage 4 strains and Lineage 3. To explore whether the long-term success of MTB Uganda family was due to increased virulence, we used cavitary disease as a proxy, as this form of TB is the most transmissible. Multivariate analysis revealed that even though cavitary disease was associated with known risk factors such as smoking (adjusted odds ratio (aOR) 4.8, 95% confidence interval (CI) 3.33-6.84) and low income (aOR 2.1, 95% CI 1.47-3.01), no association was found between MTB lineage and cavitary TB.

Conclusion

The MTB Uganda family has been dominating in Kampala for the last 18 years, but this long-term success is not due to increased virulence as defined by cavitary disease.

【 授权许可】

   
2013 Wampande et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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