Genetic Diversity and Molecular Epidemiology of Mycobacterium tuberculosis in Roraima State, Brazil

Mariana Bento Tatara Laboratory of Research in Health Science, Faculty of Health Science, Federal University of Grande Dourados, Dourados, Brazil;

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João Perdigão Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal;

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Miguel Viveiros Institute of Hygiene and Tropical Medicine (IHMT), Global Health and Tropical Medicine (GHTM), University NOVA of Lisbon, Lisbon, Portugal;

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Afrânio Kritski School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;

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Kesia Esther da Silva Laboratory of Research in Health Science, Faculty of Health Science, Federal University of Grande Dourados, Dourados, Brazil;

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Flávia Patussi Correia Sacchi Referent Center of Tuberculosis and Leprosy, Dourados Municipal Health Secretary, Dourados, Brazil;

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Camila Camioli de Lima Laboratory of Research in Health Science, Faculty of Health Science, Federal University of Grande Dourados, Dourados, Brazil;

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Paulo César Pereira dos Santos Laboratory of Research in Health Science, Faculty of Health Science, Federal University of Grande Dourados, Dourados, Brazil;

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Jaciara de Lourdes do Carmo Guimarães Diniz Nucleus of Research in Medical Microbiology, Faculty of Medicine, Federal University of Rio Grande, Rio Grande, Brazil;

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Pedro Eduardo Almeida Silva Nucleus of Research in Medical Microbiology, Faculty of Medicine, Federal University of Rio Grande, Rio Grande, Brazil;

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Pedro Gomes Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal;

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Mônica Maria Quirino Gomes Central Laboratory of Public Health of Roraima, Boa Vista, Brazil;

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Eunice Atsuko Totumi Cunha Central Laboratory of Public Health of Mato Grosso do Sul, Campo Grande, Brazil;

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José Roberto Lapa e Silva School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil;

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Isabel Portugal Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal;

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Julio Croda Oswaldo Cruz Foundation, Campo Grande, Brazil;
School of Medicine, Federal University of Mato Grosso do Sul, Campo Grande, Brazil;

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Monica Kramer de N. Andrade Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

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National border areas are special places for the spread of Mycobacterium tuberculosis (MTB). These regions concentrate vulnerable populations and constant population movements. Understanding the dynamics of the transmission of MTB is fundamental to propose control measures and to monitor drug resistance. We conducted a population-based prospective study of tuberculosis (TB) to evaluate molecular characteristics of MTB isolates circulating in Roraima, a state on the border of Venezuela and Guyana. Eighty isolates were genotyped by IS6110-RFLP (restriction fragment length polymorphism), spoligotyping, and 24-locus mycobacterial interspersed repetitive unit-variable number of repeats tandem (MIRU-VNTR). Drug susceptibility tests were performed by using the proportion method and GeneXpert® MTB/RIF (Cepheid, Sunnyvale, CA). Isolates showing a phenotypic resistance profile were submitted to polymerase chain reaction (PCR) and sequencing. Spoligotyping showed 40 distinct patterns with a high prevalence of Latin-American and Mediterranean (LAM), Haarlem (H), and the “ill-defined” T clades. Mycobacterial interspersed repetitive unit -VNTR and IS6110-RFLP showed clustering rates of 21.3% and 30%, respectively. Drug resistance was detected in 11 (15.1%) isolates, and all were found to have primary resistance; among these, six (8.2%) isolates were streptomycin mono-resistant, four (5.4%) isoniazid mono-resistant, and one (1.3%) multidrug resistant. This is the first study on the molecular epidemiology and drug resistance profile of MTB from Roraima. Herein, we describe high diversity of genetic profiles circulating in this region that may be driven by the introduction of new strain types because of large population flow in this region. In summary, our results showed that analyses of these circulating strains can contribute to a better understanding of TB epidemiology in the northern Brazilian border and be useful to establish public health policies on TB prevention.

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Author Notes

Address correspondence to Monica Kramer de N. Andrade, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil. E-mail: monicakra@gmail.com

Financial support: This work was supported by Conselho Nacional de Desenvolvimento Científico (Chamada MCTI/CNPq/MS-SCTIE grants 404237/2012-6) and by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES/MEC/Brazil) grant 88881.064961/2014-01. M. B. T received a scholarship from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). J. P. was supported by a post doc fellowship (SFRH/BPD/95406/2013) from Fundação para a Ciência e Tecnologia.

Authors’ addresses: Mariana Bento Tatara, Kesia Esther da Silva, Camila Camioli de Lima, and Paulo César Pereira dos Santos, Laboratory of Research in Health Science, Faculty of Health Science, Federal University of Grande Dourados, Dourados, Brazil, E-mails: marianabtatara@gmail.com, kesia.eds@gmail.com, camiolidelima.camila@gmail.com, and paulo.cesar.pds@gmail.com. João Perdigão, Pedro Gomes, and Isabel Portugal, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal, E-mails: jrlperdigao@gmail.com, p-gomes-d@hotmail.com, and iportugal@ff.ulisboa.pt. Miguel Viveiros, Institute of Hygiene and Tropical Medicine (IHMT), Global Health and Tropical Medicine (GHTM), University NOVA of Lisbon, Lisbon, Portugal, E-mail: mviveiros@ihmt.unl.pt. Afrânio Kritski and José Roberto Lapa e Silva, School of Medicine, Federal University of Rio de Janeiro. Rio de Janeiro, Brazil, E-mails: kritskia@gmail.com and jrlapa@hotmail.com. Flávia Patussi Correia Sacchi, Referent Center of Tuberculosis and Leprosy, Dourados Municipal Health Secretary, Dourados, Brazil, E-mail: fpatussi@gmail.com. Jaciara de Lourdes do Carmo Guimarães Diniz and Pedro Eduardo Almeida Silva Nucleus of Research in Medical Microbiology, Faculty of Medicine, Federal University of Rio Grande, Rio Grande, Brazil, E-mail: jaciara_1988@hotmail.com and pedrefurg@gmail.com. Mônica Maria Quirino Gomes, Central Laboratory of Public Health of Roraima, Boa Vista, Brazil, E-mail: quirinomonica@yahoo.com.br. Eunice Atsuko Totumi Cunha, Central Laboratory of Public Health of Mato Grosso do Sul, Campo Grande, Brazil, E-mail: euniceatsuko@uol.com.br. Julio Croda, Oswaldo Cruz Foundation, Campo Grande, Brazil, E-mail: juliocroda@gmail.com. Monica Kramer de N. Andrade, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, E-mail: monicakra@gmail.com.

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