A whole-genome sequencing study of an X-family tuberculosis outbreak focus on transmission chain along 25 years

Lineage 4/X-family of Mycobacterium tuberculosis is not very notorious, except for the CDC1551 strain. One strain of this family, named Ara50, caused one of the largest tuberculosis outbreaks of the Aragon region, Spain, during the 1990s and remained until 2018. These X-strains are characterised by...

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Published inTuberculosis (Edinburgh, Scotland) Vol. 126; p. 102022
Main Authors Comín, Jessica, Cebollada, Alberto, Ibarz, Daniel, Viñuelas, Jesús, Vitoria, María Asunción, Iglesias, María José, Samper, Sofía
Format Journal Article
LanguageEnglish
Published Scotland Elsevier Ltd 01.01.2021
Elsevier Science Ltd
Subjects
Copy number
Drug abuse
Epidemiology
Gene sequencing
Genomes
HIV
Homelessness
Human immunodeficiency virus
Intravenous administration
Latency
Outbreaks
Public health
Single-nucleotide polymorphism
Tuberculosis
Tuberculosis outbreak
Virulence
Virulence factors
Whole genome sequencing
X-family tuberculosis strain
Tuberculosis outbreak
X-family tuberculosis strain
Tuberculosis
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Summary:Lineage 4/X-family of Mycobacterium tuberculosis is not very notorious, except for the CDC1551 strain. One strain of this family, named Ara50, caused one of the largest tuberculosis outbreaks of the Aragon region, Spain, during the 1990s and remained until 2018. These X-strains are characterised by high transmissibility and by carrying a low copy number of IS6110 in their genomes. Epidemiological data of the 61 patients consisted of inmates, HIV seropositives, intravenous drug users and the homeless. The application of whole-genome sequencing (WGS) to 36 out of 61 isolates, selected by IS6110-RFLP, allowed to confirm 32 as recent transmissions. We found 10 SNPs in genes considered as virulence factors, five of them specific of this strain. WGS identified three sub-clusters (CLSs). The largest one, sub-CLS 1, included 10 cases. Seven of them shared a SNP in the mce3C gene, considered a virulence factor gene. Sub-CLS 2 involved familiar cases, and no link was known for sub-CLS 3. Finally, the strain showed efficacy in latency as a confirmed epidemiological link was established between two cases, with 6 years of distance in their diagnosis. This outbreak study combined epidemiological and molecular analyses in order to elucidate tuberculosis transmission.
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ISSN:1472-9792
1873-281X
DOI:10.1016/j.tube.2020.102022