title: Phylogenetic lineages of tuberculosis isolates in New Zealand and their association with patient demographics.
abstract: METHODS
  In New Zealand, the lineage genotypes of Mycobacterium tuberculosis clinical isolates and their role in the epidemiology of tuberculosis (TB) are currently unknown.
  
  
  OBJECTIVE
  1) To measure the relative frequency of each phylogenetic lineage of the M. tuberculosis complex in New Zealand, and 2) to examine its relationship with patient demographics and multidrug-resistant TB (MDR-TB).
  
  
  METHODS
  All non-duplicate M. tuberculosis complex isolates recovered in 2010 and 2011 underwent large sequence polymorphism and/or single nucleotide polymorphism analyses. Mycobacterial interspersed repetitive units (MIRU) profiling was also performed for cluster identification.
  
  
  RESULTS
  New Zealand isolates were dominated by lineage 4 (Euro-American: 37.8%, 95%CI 33.6-42.2), followed by lineage 1 (Indo-Oceanic: 22.6%, 95%CI 19.1-26.5), lineage 2 (East Asian: 19.5%, 95%CI 16.2-23.3) and lineage 3 (East-African Indian, which included Central Asian: 17.7%, 95%CI 14.5-21.3). Lineage 2 accounted for 58.1% of MDR-TB cases from 2002 to 2011. Among immigrants, the predominant lineages corresponded to high prevalence lineages in the country of origin. In New Zealand-born individuals, Māori and NZ Europeans share the same predominant lineage, lineage 4, with a higher proportion of non-unique MIRU types observed in Māori cases. Lineage 3 was more prevalent in Māori than in NZ Europeans.
  
  
  CONCLUSIONS
  In New Zealand, M. tuberculosis complex phylogenetic lineage is associated with TB epidemiology in terms of ethnicity, country of origin and MDR-TB.
authors: School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand.
authors: S
authors: S
authors: Yen
authors: J E
authors: JE
authors: Bower
authors: J T
authors: JT
authors: Freeman
authors: I
authors: I
authors: Basu
authors: R F
authors: RF
authors: O'Toole
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000494:pharmacology*; D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D054242:Emigrants and Immigrants; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification*; D009520:New Zealand / Q000453:epidemiology; D010802:Phylogeny; D020641:Polymorphism, Single Nucleotide; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents