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Classifying recurrent Mycobacterium tuberculosis cases in Georgia using MIRU-VNTR typing
Nino Maghradze1,2,3, Levan Jugheli1,2,3, Sonia Borrell1,2
1Swiss Tropical and Public Health Institute, Basel, Switzerland.
Plos One
|October 19, 2019
Summary
Recurrent multidrug-resistant tuberculosis in Georgia is mainly due to relapse, not reinfection. This suggests potential issues with the TB control program and highlights the need for improved infection control, especially in prisons.
Area of Science:
- Microbiology
- Epidemiology
- Public Health
Background:
- Recurrent tuberculosis (TB) presents a significant challenge to global TB control efforts.
- Differentiating between TB relapse and reinfection is crucial for effective intervention strategies.
- Georgia lacks data on the causes of recurrent TB, hindering targeted control measures.
Purpose of the Study:
- To implement Mycobacterial Interspersed Repetitive Units-Variable Tandem Repeats (MIRU-VNTR) genotyping at the National Center for Tuberculosis and Lung Diseases (NCTBLD).
- To distinguish between relapse and reinfection in multidrug-resistant (MDR-) TB patients in Tbilisi, Georgia.
- To identify predictors of TB recurrence in this patient population.
Main Methods:
- MIRU-VNTR 24 loci genotyping was performed on paired bacterial samples from recurrent MDR-TB cases (2014-2016).
- Relapse was defined as identical or one locus difference in MIRU-VNTR patterns; reinfection was defined as two or more loci differences.
- Exact logistic regression was employed to analyze predictors of recurrence.
Main Results:
- 32 MDR-TB patients (64 samples) were analyzed.
- 25 patients (83.3%) experienced relapse, while 5 patients (16.7%) had reinfection.
- A history of incarceration was significantly associated with TB reinfection (p<0.05).
Conclusions:
- The majority of recurrent MDR-TB cases in Georgia are attributed to relapse, raising concerns about the current TB control program's effectiveness.
- The association between incarceration and reinfection suggests high TB transmission rates within correctional facilities, necessitating enhanced infection control.
- Implementing genotypic surveillance for TB is recommended to strengthen TB control strategies in Georgia.
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