TY - JOUR
T1 - Genomic epidemiological analysis identifies high relapse among individuals with recurring tuberculosis and provides evidence of recent household-related transmission of tuberculosis in Ghana
AU - Asare, Prince
AU - Osei-Wusu, Stephen
AU - Baddoo, Nyonuku Akosua
AU - Bedeley, Edmund
AU - Otchere, Isaac Darko
AU - Brites, Daniela
AU - Loiseau, Chloé
AU - Asante-Poku, Adwoa
AU - Prah, Diana Ahu
AU - Borrell, Sonia
AU - Reinhard, Miriam
AU - Omari, Michael Amo
AU - Forson, Audrey
AU - Koram, Kwadwo Ansah
AU - Gagneux, Sebastien
AU - Yeboah-Manu, Dorothy
N1 - Publisher Copyright:
© 2021 The Author(s)
PY - 2021/5
Y1 - 2021/5
N2 - Objective: To retrospectively investigate the cause of recurring tuberculosis (rcTB) among participants with pulmonary TB recruited from a prospective population-based study conducted between July 2012 and December 2015. Methods: Mycobacterium tuberculosis complex isolates obtained from rcTB cases were characterized by standard mycobacterial genotyping tools, whole-genome sequencing, and phylogenetic analysis carried out to assess strain relatedness. Results: The majority (58.3%, 21/36) of study participants with rcTB episodes had TB recurrence within 12 months post treatment. TB strains with isoniazid (INH) resistance were found in 19.4% (7/36) of participants at the primary episode, of which 29% (2/7) were also rifampicin-resistant. On TB recurrence, an INH-resistant strain was found in a larger proportion of participants, 27.8% (10/36), of which 40% (4/10) were MDR-TB strains. rcTB was attributed to relapse (same strain) in 75.0% (27/36) of participants and 25.0% (9/36) to re-infection. Conclusion: Our findings indicate that previous unresolved infectiondue to inadequate treatment, may be the major cause of rcTB.
AB - Objective: To retrospectively investigate the cause of recurring tuberculosis (rcTB) among participants with pulmonary TB recruited from a prospective population-based study conducted between July 2012 and December 2015. Methods: Mycobacterium tuberculosis complex isolates obtained from rcTB cases were characterized by standard mycobacterial genotyping tools, whole-genome sequencing, and phylogenetic analysis carried out to assess strain relatedness. Results: The majority (58.3%, 21/36) of study participants with rcTB episodes had TB recurrence within 12 months post treatment. TB strains with isoniazid (INH) resistance were found in 19.4% (7/36) of participants at the primary episode, of which 29% (2/7) were also rifampicin-resistant. On TB recurrence, an INH-resistant strain was found in a larger proportion of participants, 27.8% (10/36), of which 40% (4/10) were MDR-TB strains. rcTB was attributed to relapse (same strain) in 75.0% (27/36) of participants and 25.0% (9/36) to re-infection. Conclusion: Our findings indicate that previous unresolved infectiondue to inadequate treatment, may be the major cause of rcTB.
KW - Molecular epidemiology
KW - Mycobacterium africanum
KW - Mycobacterium tuberculosis
KW - Relapse
KW - Tuberculosis
KW - Whole-genome sequencing
UR - http://www.scopus.com/inward/record.url?scp=85103672132&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2021.02.110
DO - 10.1016/j.ijid.2021.02.110
M3 - Article
C2 - 33667696
AN - SCOPUS:85103672132
SN - 1201-9712
VL - 106
SP - 13
EP - 22
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -