title: First molecular epidemiology study of Mycobacterium tuberculosis in Kiribati.
abstract: Tuberculosis incidence rates in Kiribati are among the highest in the Western Pacific Region, however the genetic diversity of circulating Mycobacterium tuberculosis complex strains (MTBC) and transmission dynamics are unknown. Here, we analysed MTBC strains isolated from culture positive pulmonary tuberculosis (TB) cases from the main TB referral centre between November 2007 and October 2009. Strain genotyping (IS6110 typing, spoligotyping, 24-loci MIRU-VNTR and SNP typing) was performed and demographic information collected. Among 73 MTBC strains analysed, we identified seven phylogenetic lineages, dominated by Beijing strains (49%). Beijing strains were further differentiated in two main branches, Beijing-A (n = 8) and -B (n = 28), that show distinct genotyping patterns and are characterized by specific deletion profiles (Beijing A: only RD105, RD207 deleted; Beijing B: RD150 and RD181 additionally deleted). Many Kiribati strains (59% based on IS6110 typing of all strains) occurred in clusters, suggesting ongoing local transmission. Beijing-B strains and over-crowded living conditions were associated with strain clustering (likely recent transmission), however little evidence of anti-tuberculous drug resistance was observed. We suggest enhanced case finding amongst close contacts and continued supervised treatment of all identified cases using standard first-line drugs to reduce TB burden in Kiribati. Beijing strains can be subdivided in different principle branches that might be associated with differential spreading patterns in the population.
authors: Centre for Virology, Burnet Institute, Melbourne, Australia. eman@burnet.edu.au
authors: Eman
authors: E
authors: Aleksic
authors: Matthias
authors: M
authors: Merker
authors: Helen
authors: H
authors: Cox
authors: Bereka
authors: B
authors: Reiher
authors: Zamberi
authors: Z
authors: Sekawi
authors: Anna C
authors: AC
authors: Hearps
authors: Claire E
authors: CE
authors: Ryan
authors: Adele V
authors: AV
authors: Lee
authors: Regis
authors: R
authors: Goursaud
authors: Clement
authors: C
authors: Malau
authors: Janet
authors: J
authors: O'Connor
authors: Catherine L
authors: CL
authors: Cherry
authors: Stefan
authors: S
authors: Niemann
authors: Suzanne M
authors: SM
authors: Crowe
mesh_terms: D016000:Cluster Analysis; D017931:DNA Primers / Q000235:genetics; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D008849:Micronesia / Q000453:epidemiology; D018598:Minisatellite Repeats / Q000235:genetics; D017720:Molecular Epidemiology; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis / Q000235:genetics*; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length / Q000235:genetics; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D013045:Species Specificity; D018709:Statistics, Nonparametric; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D017931:DNA Primers
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