A One Health approach revealed the long-term role of Mycobacterium caprae as the hidden cause of human tuberculosis in a region of Spain, 2003 to 2022

Introduction is a member of the complex (MTBC) not routinely identified to species level. It lacks specific clinical features of presentation and may therefore not be identified as the causative agent of tuberculosis. Use of whole genome sequencing (WGS) in the investigation of a family microepidemi...

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Published in:	Euro surveillance : bulletin européen sur les maladies transmissibles Vol. 28; no. 12
Main Authors:	Martínez-Lirola, Miguel, Herranz, Marta, Buenestado Serrano, Sergio, Rodríguez-Grande, Cristina, Dominguez Inarra, Eva, Garrido-Cárdenas, Jose Antonio, Correa Ruiz, Ana María, Bermúdez, María Pilar, Causse Del Río, Manuel, González Galán, Verónica, Liró Armenteros, Julia, Viudez Martínez, Jose María, Vallejo-Godoy, Silvia, Esteban García, Ana Belén, Cabezas Fernández, María Teresa, Muñoz, Patricia, Pérez Lago, Laura, García de Viedma, Darío
Format:	Journal Article
Language:	English
Published:	Sweden Centre Europeen pour la Surveillance Epidemiologique du SIDA (European Centre for the Epidemiological Monitoring of AIDS) 23-03-2023 European Centre for Disease Prevention and Control (ECDC)
Subjects:	Animals Epidemics Epidemiology Genomes Genomics Humans Mycobacterium - genetics Mycobacterium tuberculosis One Health Spain - epidemiology Tuberculosis Tuberculosis - diagnosis Tuberculosis - epidemiology Tuberculosis - microbiology Zoonoses Spain WGS Tuberculosis M. caprae One Health
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Summary:	Introduction is a member of the complex (MTBC) not routinely identified to species level. It lacks specific clinical features of presentation and may therefore not be identified as the causative agent of tuberculosis. Use of whole genome sequencing (WGS) in the investigation of a family microepidemic of tuberculosis in Almería, Spain, unexpectedly identified the involvement of .AimWe aimed to evaluate the presence of additional unidentified cases and to determine the magnitude of this occurrence.MethodsFirst-line characterisation of the MTBC isolates was done by MIRU-VNTR, followed by WGS. Human and animal isolates were integrated in the analysis.ResultsA comprehensive One Health strategy allowed us to (i) detect other 11 infections in humans in a period of 18 years, (ii) systematically analyse infections on an epidemiologically related goat farm and (iii) geographically expand the study by including 16 isolates from other provinces. Integrative genomic analysis of 41 human and animal isolates showed a high diversity of strains. The animal isolates' diversity was compatible with long-term infection, and close genomic relationships existed between isolates from goats on the farm and recent cases of infection in humans.DiscussionZoonotic circulation of strains had gone unnoticed for 18 years. Systematic characterisation of MTBC at species level and/or extended investigation of the possible sources of exposure in all tuberculosis cases would minimise the risk of overlooking similar zoonotic events.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 These authors contributed equally and share last authorship Correspondence: Darío García de Viedma (dgviedma2@gmail.com)
ISSN:	1560-7917 1025-496X 1560-7917
DOI:	10.2807/1560-7917.ES.2023.28.12.2200852