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Whole genome analysis of extensively drug resistant Mycobacterium tuberculosis strains in Peru

David Santos-Lazaro1, Ronnie G Gavilan1,2, Lely Solari1

  • 1Instituto Nacional de Salud, Lima, Peru.

Scientific Reports
|May 5, 2021
PubMed

Insights

Genomic characterization of extensively drug-resistant tuberculosis (XDR-TB) strains in Peru reveals high drug resistance and limited recent transmission. Whole genome sequencing (WGS) identified key mutations and evolutionary patterns of circulating XDR-TB.

Area of Science:

  • Genomics
  • Microbiology
  • Public Health

Background:

  • Peru faces a significant burden of multidrug-resistant tuberculosis (MDR-TB), with increasing cases of extensively drug-resistant tuberculosis (XDR-TB).
  • XDR-TB presents a major public health challenge in the Americas region, necessitating advanced characterization of circulating strains.

Purpose of the Study:

  • To conduct genomic characterization of Mycobacterium tuberculosis strains from Peruvian patients diagnosed with XDR-TB between 2011 and 2015.
  • To identify drug resistance mutations, analyze transmission patterns, and understand evolutionary dynamics of XDR-TB strains in Peru.

Main Methods:

  • Whole genome sequencing (WGS) was performed on 68 XDR-TB strains collected from various regions in Peru.
  • Genomic data was analyzed to identify lineages, drug resistance mutations, and transmission links using single nucleotide polymorphism (SNP) cluster analysis.

Main Results:

  • The majority of strains (91.2%) belonged to the Euro-American Lineage, with 85.3% originating from Lima and Callao.
  • Approximately 90% of strains exhibited high-confidence drug resistance mutations, with some discrepancies noted compared to commercial molecular assays.
  • Cluster analysis indicated limited recent transmission, with only 34% of strains showing links within a 10 SNP cut-off.

Conclusions:

  • WGS is a valuable high-resolution tool for predicting drug resistance in XDR-TB strains.
  • Genomic analysis aids in understanding strain transmission and evolutionary patterns, crucial for public health interventions in Peru.
  • The study underscores the utility of WGS in combating the XDR-TB epidemic in Peru.

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