Genomic investigation of bone tuberculosis highlighted the role of subclinical pulmonary tuberculosis in transmission

IF 2.8 3区医学 Q3 IMMUNOLOGY

Tuberculosis Pub Date : 2024-06-13 DOI:10.1016/j.tube.2024.102534

Jinfeng Yin , Guangxuan Yan , Liyi Qin , Chendi Zhu , Jun Fan , Yuwei Li , Junnan Jia , Zhaojun Wu , Hui Jiang , Muhammad Tahir Khan , Jiangdong Wu , Naihui Chu , Howard E. Takiff , Qian Gao , Shibing Qin , Qingyun Liu , Weimin Li

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引用次数: 0

Abstract

Background

Extrapulmonary tuberculosis (EPTB) without symptomatic pulmonary involvement has been thought to be non-transmissible, but EPTB with asymptomatic pulmonary tuberculosis (PTB) could transmit tuberculosis (TB). Genomic investigation of Mycobacterium tuberculosis (Mtb) isolates from EPTB may provide insight into its epidemiological role in TB transmission.

Methods

Between January 2017 and May 2020, 107 Mtb isolates were obtained from surgical drainage of bone TB patients at the Beijing Chest Hospital, and 218 Mtb strains were isolated from PTB cases. These 325 Mtb isolates were whole-genome sequenced to reconstruct a phylogenetic tree, identify transmission clusters, and infer transmission links using a Bayesian approach. Possible subclinical PTB in the bone TB patients was investigated with chest imaging by two independent experts.

Results

Among 107 bone TB patients, 10 were in genomic clusters (≤12 SNPs). Phylogenetic analysis suggested that three bone TB patients transmitted the infection to secondary cases, supported by epidemiological investigations. Pulmonary imaging of 44 bone TB patients revealed that 79.5 % (35/44) had radiological abnormalities suggestive of subclinical PTB.

Conclusions

This study provides genomic evidence that bone TB patients without clinically diagnosed PTB can be sources of TB transmission, underscoring the importance of screening for subclinical, transmissible PTB among EPTB cases.

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骨结核基因组调查凸显亚临床肺结核在传播中的作用

背景无症状肺部受累的肺外结核（EPTB）一直被认为是不传播的，但无症状肺结核（PTB）的EPTB可能传播结核病（TB）。对来自EPTB的结核分枝杆菌（Mtb）分离株进行基因组学调查，可能有助于了解其在结核病传播中的流行病学作用。方法在2017年1月至2020年5月期间，从北京胸科医院骨结核患者的手术引流中获得了107株Mtb分离株，从PTB病例中分离出218株Mtb菌株。对这325株Mtb分离株进行了全基因组测序，利用贝叶斯方法重建了系统发生树，确定了传播集群，并推断了传播联系。两名独立专家通过胸部影像学检查了骨结核患者中可能存在的亚临床 PTB。系统发生学分析表明，3 名骨结核病人将感染传染给了继发病例，流行病学调查也证实了这一点。44例骨结核患者的肺部成像显示，79.5%（35/44）的骨结核患者出现放射学异常，提示为亚临床型PTB。结论：该研究提供了基因组学证据，表明未被临床诊断为PTB的骨结核患者可能是结核病的传播源，强调了在EPTB病例中筛查亚临床型可传播PTB的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tuberculosis 医学-呼吸系统

CiteScore

4.60

自引率

3.10%

发文量

审稿时长

49 days

期刊介绍： Tuberculosis is a speciality journal focusing on basic experimental research on tuberculosis, notably on bacteriological, immunological and pathogenesis aspects of the disease. The journal publishes original research and reviews on the host response and immunology of tuberculosis and the molecular biology, genetics and physiology of the organism, however discourages submissions with a meta-analytical focus (for example, articles based on searches of published articles in public electronic databases, especially where there is lack of evidence of the personal involvement of authors in the generation of such material). We do not publish Clinical Case-Studies. Areas on which submissions are welcomed include: -Clinical TrialsDiagnostics- Antimicrobial resistance- Immunology- Leprosy- Microbiology, including microbial physiology- Molecular epidemiology- Non-tuberculous Mycobacteria- Pathogenesis- Pathology- Vaccine development. This Journal does not accept case-reports. The resurgence of interest in tuberculosis has accelerated the pace of relevant research and Tuberculosis has grown with it, as the only journal dedicated to experimental biomedical research in tuberculosis.