Transmission characteristics in Tuberculosis by WGS: nationwide cross-sectional surveillance in China

China, with the third largest share of global tuberculosis cases, faces a substantial challenge in its healthcare system as a result of the high burden of multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB). This study employs a genomic epidemiological approach to assess recent tub...

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Main Authors: Dongxin Liu, Fei Huang, Yaru Li, Lingfeng Mao, Wencong He, Sihao Wu, Hui Xia, Ping He, Huiwen Zheng, Yang Zhou, Bing Zhao, Xichao Ou, Yuanyuan Song, Zexuan Song, Li Mei, Li Liu, Guoliang Zhang, Qiang Wei, Yanlin Zhao
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Emerging Microbes and Infections
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Online Access:https://www.tandfonline.com/doi/10.1080/22221751.2024.2348505
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author Dongxin Liu
Fei Huang
Yaru Li
Lingfeng Mao
Wencong He
Sihao Wu
Hui Xia
Ping He
Huiwen Zheng
Yang Zhou
Bing Zhao
Xichao Ou
Yuanyuan Song
Zexuan Song
Li Mei
Li Liu
Guoliang Zhang
Qiang Wei
Yanlin Zhao
author_facet Dongxin Liu
Fei Huang
Yaru Li
Lingfeng Mao
Wencong He
Sihao Wu
Hui Xia
Ping He
Huiwen Zheng
Yang Zhou
Bing Zhao
Xichao Ou
Yuanyuan Song
Zexuan Song
Li Mei
Li Liu
Guoliang Zhang
Qiang Wei
Yanlin Zhao
author_sort Dongxin Liu
collection DOAJ
description China, with the third largest share of global tuberculosis cases, faces a substantial challenge in its healthcare system as a result of the high burden of multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB). This study employs a genomic epidemiological approach to assess recent tuberculosis transmissions between individuals, identifying potential risk factors and discerning the role of transmitted resistant isolates in the emergence of drug-resistant tuberculosis in China. We conducted a population-based retrospective study on 5052 Mycobacterium tuberculosis (MTB) isolates from 70 surveillance sites using whole genome sequencing (WGS). Minimum spanning tree analysis identified resistance mutations, while epidemiological data analysis pinpointed transmission risk factors. Of the 5052 isolates, 23% (1160) formed 452 genomic clusters, with 85.6% (387) of the transmissions occurring within the same counties. Individuals with younger age, larger family size, new cases, smear positive, and MDR/RR were at higher odds for recent transmission, while higher education (university and above) and occupation as a non-physical workers emerged as protective factors. At least 61.4% (251/409) of MDR/RR-TB were likely a result of recent transmission of MDR/RR isolates, with previous treatment (crude OR =   2.77), smear-positive (cOR =   2.07) and larger family population (cOR = 1.13) established as risk factors. Our findings highlight that local transmission remains the predominant form of TB transmission in China. Correspondingly, drug-resistant tuberculosis is primarily driven by the transmission of resistant tuberculosis isolates. Targeted interventions for high-risk populations to interrupt transmission within the country will likely provide an opportunity to reduce the prevalence of both tuberculosis and drug-resistant tuberculosis.
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spelling doaj-art-fe0acb32c22b47049e29714030cb7e202024-12-07T04:40:16ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512024-12-0113110.1080/22221751.2024.2348505Transmission characteristics in Tuberculosis by WGS: nationwide cross-sectional surveillance in ChinaDongxin Liu0Fei Huang1Yaru Li2Lingfeng Mao3Wencong He4Sihao Wu5Hui Xia6Ping He7Huiwen Zheng8Yang Zhou9Bing Zhao10Xichao Ou11Yuanyuan Song12Zexuan Song13Li Mei14Li Liu15Guoliang Zhang16Qiang Wei17Yanlin Zhao18National Pathogen Resource Center, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaDepartment of Nutrition, Beijing Friendship Hospital, Capital Medical UniversityJoint Research Center for Molecular Diagnosis of Severe Infection in Children, Binjiang Institute of Zhejiang University, Hangzhou, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaJoint Research Center for Molecular Diagnosis of Severe Infection in Children, Binjiang Institute of Zhejiang University, Hangzhou, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaLaboratory of Respiratory Diseases, Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, National Center for Children’s Health, Beijing, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Pathogen Resource Center, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Pathogen Resource Center, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Clinical Research Center for Infectious Diseases, Guangdong Clinical Research Center for Tuberculosis, Shenzhen Third People’s Hospital, Shenzhen, People’s Republic of ChinaNational Pathogen Resource Center, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaNational Tuberculosis Reference Laboratory, National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of ChinaChina, with the third largest share of global tuberculosis cases, faces a substantial challenge in its healthcare system as a result of the high burden of multidrug-resistant and rifampicin-resistant tuberculosis (MDR/RR-TB). This study employs a genomic epidemiological approach to assess recent tuberculosis transmissions between individuals, identifying potential risk factors and discerning the role of transmitted resistant isolates in the emergence of drug-resistant tuberculosis in China. We conducted a population-based retrospective study on 5052 Mycobacterium tuberculosis (MTB) isolates from 70 surveillance sites using whole genome sequencing (WGS). Minimum spanning tree analysis identified resistance mutations, while epidemiological data analysis pinpointed transmission risk factors. Of the 5052 isolates, 23% (1160) formed 452 genomic clusters, with 85.6% (387) of the transmissions occurring within the same counties. Individuals with younger age, larger family size, new cases, smear positive, and MDR/RR were at higher odds for recent transmission, while higher education (university and above) and occupation as a non-physical workers emerged as protective factors. At least 61.4% (251/409) of MDR/RR-TB were likely a result of recent transmission of MDR/RR isolates, with previous treatment (crude OR =   2.77), smear-positive (cOR =   2.07) and larger family population (cOR = 1.13) established as risk factors. Our findings highlight that local transmission remains the predominant form of TB transmission in China. Correspondingly, drug-resistant tuberculosis is primarily driven by the transmission of resistant tuberculosis isolates. Targeted interventions for high-risk populations to interrupt transmission within the country will likely provide an opportunity to reduce the prevalence of both tuberculosis and drug-resistant tuberculosis.https://www.tandfonline.com/doi/10.1080/22221751.2024.2348505Tuberculosistransmissionrisk factorsMDR/RR-TBwhole genome sequencing
spellingShingle Dongxin Liu
Fei Huang
Yaru Li
Lingfeng Mao
Wencong He
Sihao Wu
Hui Xia
Ping He
Huiwen Zheng
Yang Zhou
Bing Zhao
Xichao Ou
Yuanyuan Song
Zexuan Song
Li Mei
Li Liu
Guoliang Zhang
Qiang Wei
Yanlin Zhao
Transmission characteristics in Tuberculosis by WGS: nationwide cross-sectional surveillance in China
Emerging Microbes and Infections
Tuberculosis
transmission
risk factors
MDR/RR-TB
whole genome sequencing
title Transmission characteristics in Tuberculosis by WGS: nationwide cross-sectional surveillance in China
title_full Transmission characteristics in Tuberculosis by WGS: nationwide cross-sectional surveillance in China
title_fullStr Transmission characteristics in Tuberculosis by WGS: nationwide cross-sectional surveillance in China
title_full_unstemmed Transmission characteristics in Tuberculosis by WGS: nationwide cross-sectional surveillance in China
title_short Transmission characteristics in Tuberculosis by WGS: nationwide cross-sectional surveillance in China
title_sort transmission characteristics in tuberculosis by wgs nationwide cross sectional surveillance in china
topic Tuberculosis
transmission
risk factors
MDR/RR-TB
whole genome sequencing
url https://www.tandfonline.com/doi/10.1080/22221751.2024.2348505
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