Mycobacterium tuberculosis lineage 4 associated with cavitations and treatment failure

• Published in: BMC infectious diseases Vol. 23; no. 1; p. 154
• Main Authors: Ordaz-Vázquez, Anabel, Torres-González, Pedro, Ferreyra-Reyes, Leticia, Canizales-Quintero, Sergio, Delgado-Sánchez, Guadalupe, García-García, Lourdes, Ponce-De-León, Alfredo, Sifuentes-Osornio, José, Bobadilla-Del-Valle, Miriam
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14-03-2023; BioMed Central; BMC
• Subjects: Analysis; BCG; BCG vaccines; Body mass index; Causes of; Cavitation; Cavitation resistance; Cavitations; Clinical association; Clinical outcomes; Complications and side effects; Development and progression; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Drug resistance in microorganisms; Drug therapy; Failure; Genetic aspects; Genetic diversity; Genotype; Genotyping; Health services; Hemoptysis; HIV; Human immunodeficiency virus; Humans; Identification and classification; Lineage 4; Minisatellite Repeats; Multidrug resistance; Mycobacterium tuberculosis; Mycobacterium tuberculosis - genetics; Patients; Phylogeny; Pulmonary tuberculosis; Regression analysis; Risk factors; Sociodemographics; Sputum; Statistical analysis; Treatment failure; Tuberculosis; Tuberculosis - microbiology; Tuberculosis, Pulmonary - microbiology; Variables; Mexico; Cameroon; China; Beijing China; Uganda; Ghana; Treatment failure; Cavitations; Mycobacterium tuberculosis; Lineage 4; Clinical association
• ISSN: 1471-2334; 1471-2334
• DOI: 10.1186/s12879-023-08055-9

Mycobacterium tuberculosis genotyping has been crucial to determining the distribution and impact of different families on disease clinical presentation. The aim of the study was to evaluate the associations among sociodemographic and clinical characteristics and M. tuberculosis lineages from patients with pulmonary tuberculosis in Orizaba, Veracruz, Mexico.
We analyzed data from 755 patients whose isolates were typified by 24-loci mycobacterial interspersed repetitive unit-variable number of tandem repeats (MIRU-VNTR). The associations among patient characteristics and sublineages found were evaluated using logistic regression analysis.
Among M. tuberculosis isolates, 730/755 (96.6%) were assigned to eight sublineages of lineage 4 (Euro-American). Alcohol consumption (adjusted odds ratio [aOR] 1.528, 95% confidence interval (CI) 1.041-2.243; p = 0.030), diabetes mellitus type 2 (aOR 1.625, 95% CI 1.130-2.337; p = 0.009), sputum smear positivity grade (3+) (aOR 2.198, 95% CI 1.524-3.168; p < 0.001) and LAM sublineage isolates (aOR 1.023, 95% CI 1.023-2.333; p = 0.039) were associated with the presence of cavitations. Resistance to at least one drug (aOR 25.763, 95% CI 7.096-93.543; p < 0.001) and having isolates other than Haarlem and LAM sublineages (aOR 6.740, 95% CI 1.704-26.661; p = 0.007) were associated with treatment failure. In a second model, multidrug resistance was associated with treatment failure (aOR 31.497, 95% CI 5.119-193.815; p < 0.001). Having more than 6 years of formal education was not associated with treatment failure.
Knowing M. tuberculosis genetic diversity plays an essential role in disease development and outcomes, and could have important implications for guiding treatment and improving tuberculosis control.