title: First insights into circulating Mycobacterium tuberculosis complex lineages and drug resistance in Guinea.
abstract: In this study we assessed first-line anti-tuberculosis drug resistance and the genotypic distribution of Mycobacterium tuberculosis complex (MTBC) isolates that had been collected from consecutive new tuberculosis patients enrolled in two clinical trials conducted in Guinea between 2005 and 2010. Among the total 359 MTBC strains that were analyzed in this study, 22.8% were resistant to at least one of the first line anti-tuberculosis drugs, including 2.5% multidrug resistance and 17.5% isoniazid resistance, with or without other drugs. In addition, further characterization of isolates from a subset of the two trials (n = 184) revealed a total of 80 different spoligotype patterns, 29 "orphan" and 51 shared patterns. We identified the six major MTBC lineages of human relevance, with predominance of the Euro-American lineage. In total, 132 (71.7%) of the strains were genotypically clustered, and further analysis (using the DESTUS model) suggesting significantly faster spread of LAM10_CAM family (p = 0.00016). In conclusion, our findings provide a first insight into drug resistance and the population structure of the MTBC in Guinea, with relevance for public health scientists in tuberculosis control programs.
authors.affiliation: Institute of Tropical Medicine (ITM), Antwerp, Belgium; University of Gondar, Gondar, Ethiopia.
authors.forename: Mebrat
authors.initials: M
authors.lastname: Ejo
authors.affiliation: Institute of Tropical Medicine (ITM), Antwerp, Belgium; Medical Research Council (MRC), Fajara, Gambia. Electronic address: fgehre@itg.be.
authors.forename: Florian
authors.initials: F
authors.lastname: Gehre
authors.affiliation: Reference Laboratory for Mycobacteria, Conakry, Guinea.
authors.forename: Mamadou Dian
authors.initials: MD
authors.lastname: Barry
authors.affiliation: Reference Laboratory for Mycobacteria, Conakry, Guinea; National University Hospital IgnaceDeen, Conakry, Guinea.
authors.forename: Oumou
authors.initials: O
authors.lastname: Sow
authors.affiliation: Reference Laboratory for Mycobacteria, Conakry, Guinea.
authors.forename: Nene Mamata
authors.initials: NM
authors.lastname: Bah
authors.affiliation: Reference Laboratory for Mycobacteria, Conakry, Guinea.
authors.forename: Mory
authors.initials: M
authors.lastname: Camara
authors.affiliation: National University Hospital IgnaceDeen, Conakry, Guinea.
authors.forename: Boubacar
authors.initials: B
authors.lastname: Bah
authors.affiliation: Institute of Tropical Medicine (ITM), Antwerp, Belgium.
authors.forename: Cecile
authors.initials: C
authors.lastname: Uwizeye
authors.affiliation: Institute of Tropical Medicine (ITM), Antwerp, Belgium.
authors.forename: Elie
authors.initials: E
authors.lastname: Nduwamahoro
authors.affiliation: Institute of Tropical Medicine (ITM), Antwerp, Belgium.
authors.forename: Kristina
authors.initials: K
authors.lastname: Fissette
authors.affiliation: Institute of Tropical Medicine (ITM), Antwerp, Belgium.
authors.forename: Pim
authors.initials: P
authors.lastname: De Rijk
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK; UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland.
authors.forename: Corinne
authors.initials: C
authors.lastname: Merle
authors.affiliation: UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland; Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
authors.forename: Piero
authors.initials: P
authors.lastname: Olliaro
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque, United States.
authors.forename: Marcos
authors.initials: M
authors.lastname: Burgos
authors.affiliation: Clinical Trial Division, International Union against Tuberculosis and Lung Disease, Paris, France; World Health Organization, Geneva, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Lienhardt
authors.affiliation: Institute of Tropical Medicine (ITM), Antwerp, Belgium; University of Antwerp, Antwerp, Belgium.
authors.forename: Leen
authors.initials: L
authors.lastname: Rigouts
authors.affiliation: Institute of Tropical Medicine (ITM), Antwerp, Belgium; Medical Research Council (MRC), Fajara, Gambia; New York University (NYU), New York, United States.
authors.forename: Bouke C
authors.initials: BC
authors.lastname: de Jong
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology; D016470:Bacteremia; D004352:Drug Resistance, Microbial; D016701:Guinea; D006801:Humans; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000187:drug effects* / Q000235:genetics; D015995:Prevalence; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents
keywords: Genotypes; Guinea; Resistance; Spoligotyping; Tuberculosis