Polymorphic exact tandem repeat A (PETRA): a newly defined lineage of mycobacterium tuberculosis in israel originating predominantly in Sub-Saharan Africa.
As part of the Israel National Program for Prevention and Control of Tuberculosis, the molecular epidemiology of new tuberculosis cases is monitored. Prospective screening showed that about 20% of all new cases of culture-positive tuberculosis (43 of 222) in Israel in the year 2008 were caused by certain Mycobacterium tuberculosis strains of the central Asian (CAS) spoligotype lineage. The identity and similarity of these strains by mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing form a lineage we call PETRA for polymorphic at locus ETR A. The name PETRA was given to 79 strains we have found since the year 2000, because the largest number of strains with MIRU-VNTR profiles identical other than at locus A formed three groups, including 5 of 10 strains that had deleted the ETR A region from their genomes. No PETRA strain was found to be multiple drug resistant (resistant to both isoniazid and rifampin [rifampicin]). Most patients (75% [58 of 77 patients of known origin]) infected with PETRA were of sub-Saharan African origins. The genotypes associated with the 79 PETRA lineage strains presented in this paper suggest that the PETRA lineage is a large, major contributor to new tuberculosis cases in Israel.
National Public Health Laboratory, Ministry of Health, 69 Ben-Tzvi, Tel-Aviv, Israel. paul.freidlin@phlta.health.gov.il
Paul J
PJ
Freidlin
Drora
D
Goldblatt
Hasia
H
Kaidar-Shwartz
Efrat
E
Rorman
D017954:Africa South of the Sahara / Q000453:epidemiology; D000995:Antitubercular Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques; D019295:Computational Biology; D019075:Electrophoresis, Capillary; D006801:Humans; D020071:Interspersed Repetitive Sequences / Q000235:genetics*; D007538:Isoniazid / Q000494:pharmacology*; D007557:Israel / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D018598:Minisatellite Repeats / Q000235:genetics*; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D009841:Oligonucleotides / Q000032:analysis; D011110:Polymorphism, Genetic; D012150:Polymorphism, Restriction Fragment Length; D012293:Rifampin / Q000494:pharmacology; D013045:Species Specificity; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000382:microbiology
D000995:Antitubercular Agents; D009841:Oligonucleotides; D007538:Isoniazid; D012293:Rifampin