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MULTIDRUG-RESISTANT MYCOBACTERIUM TUBERCULOSIS OF THE LATIN AMERICAN MEDITERRANEAN LINEAGE, WRONGLY IDENTIFIED AS MYCOBACTERIUM PINNIPEDII (SPOLIGOTYPE INTERNATIONAL TYPE 863 [SIT863]), CAUSING ACTIVE TUBERCULOSIS IN SOUTH BRAZIL
Dalla Costa, Elis R. et al. | Date Issued: 2015
Author
Dalla Costa, Elis R.
Vasconcelos, Sidra E. G.
Esteves, Leonardo S.
Gomes, Harrison M.
Gomes, Lia L.
Silva, Pedro Almeida da
Perdigão, João
Portugal, Isabel
Viveiros, Miguel
McNerney, Ruth
Pain, Arnab
Clark, Taane G.
Rastogi, Nalin
Unis, Gisela
Rossetti, Maria Lucia R.
Suffys, Philip Noel
Affilliation
Fundação Estadual de Produção e Pesquisa em Saúde. Porto Alegre, RS, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia Molecular Aplicada a Micobactérias. Rio de Janeiro, RJ. Brasil.
Fundação Estadual de Produção e Pesquisa em Saúde. Porto Alegre, RS, Brasil / Universidade Luterana do Brasil. Porto Alegre, RS, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia Molecular Aplicada a Micobactérias. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia Molecular Aplicada a Micobactérias. Rio de Janeiro, RJ. Brasil.
Universidade Federal do Rio Grande.Faculdade de Medicina. Nùcleo de Pesquisa em Biologia Médica. Rio Grande, RS, Brasil.
Universidade de Lisboa. Faculdade de Farmácia. Instituto de Investigação do Medicamento. Lisboa, Portugal.
Universidade de Lisboa. Faculdade de Farmácia. Instituto de Investigação do Medicamento. Lisboa, Portugal.
Universidade Nova de Lisboa. Instituto de Higiene e Medicina Tropical. Unidade de Microbiologia Médica. Saúde Global e Medicina Tropical. Lisboa, Portugal.
London School of Hygiene & Tropical Medicine. Faculty of Infectious and Tropical Diseases. London, United Kingdom.
King Abdullah University of Science and Technology. Biological and Environmental Sciences and Engineering Division. Thuwal, Kingdom of Saudi Arabia.
London School of Hygiene & Tropical Medicine. Faculty of Infectious and Tropical Diseases. London, United Kingdom / London School of Hygiene & Tropical Medicine. Faculty of Epidemiology and Population Health. London, United Kingdom.
Institut Pasteur de Guadeloupe. Unité de la Tuberculose et des Mycobactéries. Les Abymes, Guadeloupe, France.
Hospital Sanatório Partenon. Porto Alegre, RS, Brasil.
Fundação Estadual de Produção e Pesquisa em Saúde. Porto Alegre, RS, Brasil / Universidade Luterana do Brasil. Porto Alegre, RS, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Biologia Molecular Aplicada a Micobactérias. Rio de Janeiro, RJ. Brasil / Unit of Mycobacteriology at the Institute of Tropical Medicine. Antwerp, Belgium.
Abstract
We recently detected the spoligotype patterns of strains of Mycobacterium pinnipedii, a species of the Mycobacterium tuberculosis complex, in sputum samples from nine cases with pulmonary tuberculosis residing in Porto Alegre, South Brazil. Because this species is rarely encountered in humans, we further characterized these nine isolates by additional genotyping techniques, including 24-locus mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing, verification of the loci TbD1, RD9, pks15/1, RD(Rio), and fbpC, the insertion of IS6110 at a site specific to the M. tuberculosis Latin American Mediterranean (LAM) lineage, and whole-genome sequencing. The combined analysis of these markers revealed that the isolates are in fact M. tuberculosis and more specifically belong to the LAM genotype. Most of these isolates (n8) were shown to be multidrug resistant (MDR), which prompted us to perform partial sequencing of the rpoA, rpoB, rpoC, katG, and inhA genes. Seven isolates (77.8%) carried the S315T mutation in katG, and one of these (11%) also presented the C((-17)T single-nucleotide polymorphism (SNP) in inhA. Interestingly, six of the MDR isolates also presented an undescribed insertion of 12 nucleotides (CCA GAA CAA CCC) in codon 516 of rpoB. No putative compensatory mutation was found in either rpoA or rpoC. This is the first report of an M. tuberculosis LAM family strain with a convergent M. pinnipedii spoligotype. These spoligotypes are observed in genotype databases at a modest frequency, highlighting that care must be taken when identifying isolates in the M. tuberculosis complex on the basis of single genetic markers.
Keywords in Portuguese
Tuberculose
Mycobacterium tuberculosis
Resistência a medicamentos
Mycobacterium pinnipedii
América Latina
Linhagem Brasileira
Sul do Brasil
 
Keywords
Tuberculosis
Mycobacterium tuberculosis
Multidrug-Resistant
Mycobacterium pinnipedii
Latin America
Mediterranean lineage
South Brazil
 
Publisher
American Society for Microbiology
Citation
DALLA COSTA, Elis R. et al. Multidrug-Resistant Mycobacterium tuberculosis of the Latin American Mediterranean Lineage, Wrongly Identified as Mycobacterium pinnipedii (Spoligotype International Type 863 [SIT863]), Causing Active Tuberculosis in South Brazil. Journal of Clinical Microbiology, v.53, n.12, p.3805-3811, Dec. 2015.
DOI
10.1128/JCM.02012-15
ISSN
0095-1137