reduced transmissibility of east african indian strains of mycobacterium tuberculosis减少了东非的遗传性印度结核分枝杆菌菌株.pdfVIP

Reduced Transmissibility of East African Indian Strains of Mycobacterium tuberculosis 1 2 1 2 2 Amr S. Albanna , Michael B. Reed , Kimberley V. Kotar , Ashley Fallow , Fiona A. McIntosh , Marcel A. 2 1 Behr , Dick Menzies * 1 Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University, Montreal, Quebec, Canada, 2 Research Institute of the McGill University Health Centre, Montreal General Hospital, Montreal, Quebec, Canada Abstract Background: Mycobacterium tuberculosis (MTB) has been classified into 4 main lineages. Some reports have associated certain lineages with particular clinical phenotypes, but there is still insufficient information regarding the clinical and epidemiologic implications of MTB lineage variation. Methods: Using large sequence polymorphisms we classified MTB isolates from a population-based study in Montreal, Canada into the 4 major lineages, and identified the associated clinical and epidemiologic features. In addition, IS6110-RFLP and spoligotyping were used as indicators of recent TB transmission. The study population was divided into a derivation cohort, diagnosed between 2001 and 2007, and a separate validation cohort, diagnosed between 1996 and 2000. Results: In the derivation cohort, when compared to the other MTB lineages, the East African-Indian (EAI) lineage was associated with lower rates of TB transmission, as measured by: positive TST among close contacts of pulmonary TB cases (adjusted odds ratio 0.6: [95% confidence interval 0.4–0.9]), and clustered TB cases (0.3: [,0.001–0.6]). Severe forms of TB were also less likely among the EAI group (0.4: [,0.001–0.8]). There wer