New insights on tuberculosis transmission dynamics and drug susceptibility profiles among the prison population in Southern Brazil based on whole-genome sequencing

Sociedade Brasileira de Medicina Tropical. Revista

article

Anselmo, Lívia Maria Pala¹  Gallo, Juliana Failde²  Pinhata, Juliana Maira Watanabe²  Peronni, Kamila Chagas³  Silva Junior, Wilson Araújo da¹  Ruy, Patricia de Cássia¹  Conceição, Emilyn Costa⁴  Dippenaar, Anzaan⁵  Warren, Robin Mark⁴  Monroe, Aline Aparecida¹  Oliveira, Rosangela Siqueira²  Bollela, Valdes Roberto¹ 

[1] Universidade de São Paulo;Instituto Adolfo Lutz;Instituto para Pesquisa do Câncer;Stellenbosch University;University of Antwerp

关键词: Tuberculosis;    Prisons;    Whole-genome sequencing;    Drug-resistant tuberculosis;   

DOI  :  10.1590/0037-8682-0181-2022

学科分类：农业科学（综合）

来源: Sociedade Brasileira de Medicina Tropical

【 摘 要 】

Background: The rate of tuberculosis (TB) infection among the prison population (PP) in Brazil is 28 times higher than that in the general population, and prison environment favors the spread of TB. Objective: To describe TB transmission dynamics and drug resistance profiles in PP using whole-genome sequencing (WGS). Methods: This was a retrospective study of Mycobacterium tuberculosis cultivated from people incarcerated in 55 prisons between 2016 and 2019; only one isolate per prisoner was included. Information about movement from one prison to another was tracked. Clinical information was collected, and WGS was performed on isolates obtained at the time of TB diagnosis. Results: Among 134 prisoners included in the study, we detected 16 clusters with a total of 58 (43%) cases of M. tuberculosis. Clusters ranged from two to seven isolates with five or fewer single nucleotide polymorphism (SNP) differences, suggesting a recent transmission. Six (4.4%) isolates were resistant to at least one anti-TB drug. Two of these clustered together and showed resistance to rifampicin, isoniazid, and fluoroquinolones, with 100% concordance between WGS and phenotypic drug-susceptibility testing. Prisoners with clustered isolates had a high amount of movement between prisons (two to eight moves) during the study period. Conclusions: WGS demonstrated the recent transmission of TB within prisons in Brazil. The high movement among prisoners seems to be related to the transmission of the same M. tuberculosis strain within the prison system. Screening for TB before and after the movement of prisoners using rapid molecular tests could play a role in reducing transmission.

【 授权许可】

CC BY