title: Contribution of spoligotyping and MIRU-VNTRs to characterize prevalent Mycobacterium tuberculosis genotypes infecting tuberculosis patients in Morocco.
abstract: In the present study, Mycobacterium tuberculosis complex (MTBC) clinical isolates from culture-positive TB patients in Morocco were studied by spoligotyping and 12-loci MIRU-VNTR typing methods to characterize prevalent genotypes (n = 219 isolates from 208 patients). Spoligotyping resulted in 39 unique patterns and 167 strains in 30 clusters (2-50 strains per cluster). Comparison with international database showed that 29 of 39 unique patterns matched existing shared spoligotype international types (SITs). Nine shared types containing 10 strains were newly created (SIT 2891 to SIT 2899); this led to the description of 69 SITs with 206 strains and two orphan patterns. The most prevalent spoligotype was SIT42 (LAM; n = 50 or 24% of isolates). The repartition of strains according to major MTBC clades was as follows LAM (46.1%)> Haarlem (26%) >ill-defined T superfamily (22.6%) and S clade (0.96%). On the other hand, Beijing, CAS (Central Asian) and EAI (East-African Indian) strains were absent in this setting. Subsequent 12-Loci MIRU typing resulted in a total of 25 SIT/MIT clusters (n = 66 isolates, 2-6 isolates per cluster), with a resulting recent transmission rate of 22.3%. The MIRU-VNTR patterns corresponded to 69 MITs for 138 strains and 46 orphan patterns. The most frequent patterns were MIT43 (n = 8), MIT9 (n = 7) and MIT42 (n = 7). HGDI analysis of the 12 MIRU loci showed that loci 10, 23 and 40 were highly discriminative in our setting. The results also underlined the usefulness of spoligotyping and MIRU-VNTR to detect mixed infections among certain of our TB patients. Globally, the results obtained showed that TB is almost exclusively transmitted in Morocco through evolutionary-modern MTBC lineages belonging to principal genetic groups 2/3 strains (Haarlem, LAM, T), with a high level of biodiversity seen by MIRU typing. This study provides with a 1st global snapshot of MTBC population structure in Morocco, and validates the potential use of spoligotyping in conjunction with minisatellites for future investigations in Morocco that should in future ideally include optimized 15- or 24-loci MIRU-VNTRs.
authors.affiliation: Unité de Biologie et Recherches Médicales, Centre National de l'Energie, des Sciences et Techniques Nucléaires, Rabat, Morocco. Electronic address: im_chaoui@yahoo.fr.
authors.forename: Imane
authors.initials: I
authors.lastname: Chaoui
authors.affiliation: WHO Supranational TB Reference Laboratory, Unité de la Tuberculose et des Mycobactéries, Institut Pasteur de Guadeloupe, F97183 Abymes, Guadeloupe, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Zozio
authors.affiliation: Laboratoire de Référence de la Tuberculose, Institut National d'Hygiène, Rabat, Morocco.
authors.forename: Ouafae
authors.initials: O
authors.lastname: Lahlou
authors.affiliation: Laboratoire de Référence de la Tuberculose, Institut National d'Hygiène, Rabat, Morocco.
authors.forename: Radia
authors.initials: R
authors.lastname: Sabouni
authors.affiliation: Laboratoire de génétiques des mycobactéries, service de Recherches, Institut Pasteur, Tanger, Morocco.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Abid
authors.affiliation: Laboratoire de Référence de la Tuberculose, Institut National d'Hygiène, Rabat, Morocco; Laboratoire de biologie moléculaire, Institut National d'Hygiène, Rabat, Morocco.
authors.forename: Rajae
authors.initials: R
authors.lastname: El Aouad
authors.affiliation: Laboratoire de biologie moléculaire, Institut National d'Hygiène, Rabat, Morocco.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Akrim
authors.affiliation: Laboratoire de biochimie et Immunologie, Faculté des Sciences, Université Mohammed V, Rabat, Morocco.
authors.forename: Said
authors.initials: S
authors.lastname: Amzazi
authors.affiliation: WHO Supranational TB Reference Laboratory, Unité de la Tuberculose et des Mycobactéries, Institut Pasteur de Guadeloupe, F97183 Abymes, Guadeloupe, France. Electronic address: nrastogi@pasteur-guadeloupe.fr.
authors.forename: Nalin
authors.initials: N
authors.lastname: Rastogi
authors.affiliation: Unité de Biologie et Recherches Médicales, Centre National de l'Energie, des Sciences et Techniques Nucléaires, Rabat, Morocco.
authors.forename: Mohammed
authors.initials: M
authors.lastname: El Mzibri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015373:Bacterial Typing Techniques / Q000379:methods*; D005260:Female; D016680:Genome, Bacterial; D006801:Humans; D008297:Male; D008875:Middle Aged; D018598:Minisatellite Repeats; D009018:Morocco / Q000453:epidemiology; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000187:drug effects / Q000235:genetics*; D010802:Phylogeny; D058974:Phylogeography; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: MIRU-VNTRs; Molecular epidemiology; Morocco; Mycobacterium tuberculosis; Population structure; Spoligotyping