title: Genetic diversity, population structure and drug resistance of Mycobacterium tuberculosis in Peru.
abstract: This paper presents the first evaluation of the molecular epidemiology of Mycobacterium tuberculosis in Peru. We characterised 323 isolates using spoligotyping and mycobacterial interspersed repetitive units variable number tandem repeats (MIRU-VNTR) typing. We aimed to determine the levels of genetic diversity and genetic differentiation among and within Peruvian isolates and the epidemiological factors which may be driving patterns of population structure and evolution of M. tuberculosis in Peru. Our results compared to the fourth international spoligotyping database (SpolDB4) and MIRU-VNTRplus, show that the main M. tuberculosis families present are Latin American-Mediterranean, Haarlem, T, and Beijing. Bayesian clustering recovered 15 groups in the Peruvian M. tuberculosis isolates, among which two were composed mainly of orphans, implying the presence of native "Peruvian" strains not previously reported. Variable levels of association with drug resistance were observed, with Beijing genotypes not showing any association with multidrug resistance, while in other groups MIRU-VNTR loci 2, 23, 31, and 40 were found to be associated with the multidrug-resistant tuberculosis (MDR-TB) phenotype, suggesting that a linkage disequibrium between these MIRU and drug resistance loci may be present. Genetic differentiation was present among drug resistant and sensitive strains. Ethambutol appeared to be the main driver of differentiation, suggesting that strong selection pressure could have been exerted by drug treatment in Peru over recent years.
authors.affiliation: Institute of Integrative and Comparative Biology, University of Leeds, LS2 9JT, UK. ctaype@ucsd.edu
authors.forename: C A
authors.initials: CA
authors.lastname: Taype
authors.forename: J C
authors.initials: JC
authors.lastname: Agapito
authors.forename: R A
authors.initials: RA
authors.lastname: Accinelli
authors.forename: J R
authors.initials: JR
authors.lastname: Espinoza
authors.forename: S
authors.initials: S
authors.lastname: Godreuil
authors.forename: S J
authors.initials: SJ
authors.lastname: Goodman
authors.forename: A L
authors.initials: AL
authors.lastname: Bañuls
authors.forename: M A
authors.initials: MA
authors.lastname: Shaw
mesh_terms: D000293:Adolescent; D000328:Adult; D000483:Alleles; D015373:Bacterial Typing Techniques / Q000379:methods*; D001499:Bayes Theorem; D030541:Databases, Genetic; D024901:Drug Resistance, Multiple, Bacterial; D004977:Ethambutol / Q000494:pharmacology; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D015810:Linkage Disequilibrium; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018598:Minisatellite Repeats; D058889:Molecular Typing / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000235:genetics* / Q000302:isolation & purification / Q000472:pathogenicity; D010568:Peru / Q000453:epidemiology; D010802:Phylogeny; D012641:Selection, Genetic; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
chemical_list: D004977:Ethambutol