A nationwide study of multidrug-resistant tuberculosis in Portugal 2014–2017 using epidemiological and molecular clustering analyses

BMC Infectious Diseases

Rita Gaio¹  Carlos Carvalho²  Raquel Duarte³  Margarida Correia-Neves⁴  Olena Oliveira⁴  Teresa Rito⁴ 

[1] Department of Mathematics, Faculty of Sciences;Department of Public Health, Northern Regional Health Administration;EPIUnit, Instituto de Saúde Pública, Universidade do Porto;Population Health Research Domain, Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho;

关键词: Multidrug-resistant tuberculosis;    Epidemiology;    Transmission;    Risk factor;   

DOI  :  10.1186/s12879-019-4189-7

来源: DOAJ

【 摘 要 】

Abstract Background Increasing multidrug-resistant tuberculosis (MDR-TB) incidence is a major threat against TB eradication worldwide. We aim to conduct a detailed MDR-TB study in Portugal, an European country with endemic TB, combining genetic analysis and epidemiological data, in order to assess the efficiency of public health containment of MRD-TB in the country. Methods We used published MIRU-VNTR data, that we reanalysed using a phylogenetic analysis to better describe MDR-TB cases transmission occurring in Portugal from 2014 to 2017, further enriched with epidemiological data of these cases. Results We show an MDR-TB transmission scenario, where MDR strains likely arose and are transmitted within local chains. 63% of strains were clustered, suggesting high primary transmission (estimated as 50% using MIRU-VNTR data and 15% considering epidemiological links). These values are higher than those observed across Europe and even for sensitive strains in Portugal using similar methodologies. MDR-TB cases are associated with individuals born in Portugal and evolutionary analysis suggests a local evolution of strains. Consistently the sublineage LAM, the most common in sensitive strains in Europe, is the more frequent in Portugal in contrast with the remaining European MDR-TB picture where immigrant-associated Beijing strains are more common. Conclusions Despite efforts to track and contain MDR-TB strains in Portugal, their transmission patterns are still as uncontrolled as that of sensitive strains, stressing the need to reinforce surveillance and containment strategies.

【 授权许可】

Unknown