title: Genotypic diversity and drug susceptibility patterns among M. tuberculosis complex isolates from South-Western Ghana.
abstract: OBJECTIVE
  The aim of this study was to use spoligotyping and large sequence polymorphism (LSP) to study the population structure of M. tuberculosis complex (MTBC) isolates.
  
  
  METHODS
  MTBC isolates were identified using standard biochemical procedures, IS6110 PCR, and large sequence polymorphisms. Isolates were further typed using spoligotyping, and the phenotypic drug susceptibility patterns were determined by the proportion method.
  
  
  RESULTS
  One hundred and sixty-two isolates were characterised by LSP typing. Of these, 130 (80.25%) were identified as Mycobacterium tuberculosis sensu stricto (MTBss), with the Cameroon sub-lineage being dominant (N = 59/130, 45.38%). Thirty-two (19.75%) isolates were classified as Mycobacterium africanum type 1, and of these 26 (81.25%) were identified as West-Africa I, and 6 (18.75%) as West-Africa II. Spoligotyping sub-lineages identified among the MTBss included Haarlem (N = 15, 11.53%), Ghana (N = 22, 16.92%), Beijing (4, 3.08%), EAI (4, 3.08%), Uganda I (4, 3.08%), LAM (2, 1.54%), X (N = 1, 0.77%) and S (2, 1.54%). Nine isolates had SIT numbers with no identified sub-lineages while 17 had no SIT numbers. MTBss isolates were more likely to be resistant to streptomycin (p<0.008) and to any drug resistance (p<0.03) when compared to M. africanum.
  
  
  CONCLUSIONS
  This study demonstrated that overall 36.4% of TB in South-Western Ghana is caused by the Cameroon sub-lineage of MTBC and 20% by M. africanum type 1, including both the West-Africa 1 and West-Africa 2 lineages. The diversity of MTBC in Ghana should be considered when evaluating new TB vaccines.
authors.affiliation: Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana. dyeboah-manu@noguchi.mimcom.org
authors.forename: Dorothy
authors.initials: D
authors.lastname: Yeboah-Manu
authors.forename: Adwoa
authors.initials: A
authors.lastname: Asante-Poku
authors.forename: Thomas
authors.initials: T
authors.lastname: Bodmer
authors.forename: David
authors.initials: D
authors.lastname: Stucki
authors.forename: Kwadwo
authors.initials: K
authors.lastname: Koram
authors.forename: Frank
authors.initials: F
authors.lastname: Bonsu
authors.forename: Gerd
authors.initials: G
authors.lastname: Pluschke
authors.forename: Sebastien
authors.initials: S
authors.lastname: Gagneux
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005838:Genotype; D009161:Mycobacterium / Q000187:drug effects / Q000235:genetics; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic / Q000235:genetics*; D013307:Streptomycin / Q000494:pharmacology; D014454:Uganda
chemical_list: D000900:Anti-Bacterial Agents; D013307:Streptomycin