Genomic and spatial analysis reveal the transmission dynamics of tuberculosis in areas with high incidence of Zhejiang, China: A prospective cohort study

IF 2.6 4区医学 Q3 INFECTIOUS DISEASES Infection Genetics and Evolution Pub Date : 2024-05-08 DOI:10.1016/j.meegid.2024.105603

Zhengwei Liu , Xiangchen Li , Haiyan Xiong , Qingrong Zhou , Huaiming Yi , Kunyang Wu , Zonglei Zhou , Yewei Lu , Yelei Zhu , Lin Zhou , Mingwu Zhang , Junshun Gao , Junli Gao , Songhua Chen , Xiaomeng Wang , Weibing Wang

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Abstract

In the mountainous, rural regions of eastern China, tuberculosis (TB) remains a formidable challenge; however, the long-term molecular epidemiological surveillance in these regions is limited. This study aimed to investigate molecular and spatial epidemiology of TB in two mountainous, rural counties of Zhejiang Province, China, from 2015 to 2021, to elucidate the recent transmission and drug-resistance profiles. The predominant Lineage 2 (L2) Beijing family accounted for 80.1% of total 532 sequenced Mycobacterium tuberculosis (Mtb) strains, showing consistent prevalence over seven years. Gene mutations associated with drug resistance were identified in 19.4% (103/532) of strains, including 47 rifampicin or isoniazid-resistant strains, eight multi-drug-resistant (MDR) strains, and five pre-extensively drug-resistant (pre-XDR) strains. Genomic clustering revealed 53 distinct clusters with an overall transmission clustering rate of 23.9% (127/532). Patients with a history of retreatment and those infected with L2 strains had a higher risk of recent transmission. Spatial and epidemiological analysis unveiled significant transmission hotspots, especially in densely populated urban areas, involving various public places such as medical institutions, farmlands, markets, and cardrooms. The study emphasizes the pivotal role of Beijing strains and urban-based TB transmission in the western mountainous regions in Zhejiang, highlighting the urgent requirement for specific interventions to mitigate the impact of TB in these unique communities.

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基因组和空间分析揭示中国浙江结核病高发地区的传播动态：一项前瞻性队列研究。

在中国东部的山区和农村地区，结核病（TB）仍然是一项艰巨的挑战；然而，这些地区的长期分子流行病学监测却十分有限。本研究旨在调查 2015 年至 2021 年中国浙江省两个山区农村县的结核病分子和空间流行病学，以阐明近期的传播和耐药性概况。在测序的532株结核分枝杆菌（Mtb）菌株中，以北京2系（L2）为主，占80.1%，七年来发病率保持一致。在19.4%（103/532）的菌株中发现了与耐药性相关的基因突变，包括47株利福平或异烟肼耐药菌株、8株多重耐药（MDR）菌株和5株前广泛耐药（Pre-XDR）菌株。基因组聚类发现了 53 个不同的聚类，总体传播聚类率为 23.9%（127/532）。有再治疗史的患者和感染 L2 菌株的患者近期传播的风险较高。空间和流行病学分析揭示了重要的传播热点，尤其是在人口稠密的城市地区，涉及医疗机构、农田、市场和棋牌室等各种公共场所。该研究强调了北京菌株和以城市为基础的结核病传播在浙江西部山区的关键作用，突出表明迫切需要采取特定干预措施，以减轻结核病对这些特殊社区的影响。

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

Infection Genetics and Evolution 医学-传染病学

CiteScore

8.40

自引率

0.00%

发文量

215

审稿时长

82 days

期刊介绍： (aka Journal of Molecular Epidemiology and Evolutionary Genetics of Infectious Diseases -- MEEGID) Infectious diseases constitute one of the main challenges to medical science in the coming century. The impressive development of molecular megatechnologies and of bioinformatics have greatly increased our knowledge of the evolution, transmission and pathogenicity of infectious diseases. Research has shown that host susceptibility to many infectious diseases has a genetic basis. Furthermore, much is now known on the molecular epidemiology, evolution and virulence of pathogenic agents, as well as their resistance to drugs, vaccines, and antibiotics. Equally, research on the genetics of disease vectors has greatly improved our understanding of their systematics, has increased our capacity to identify target populations for control or intervention, and has provided detailed information on the mechanisms of insecticide resistance. However, the genetics and evolutionary biology of hosts, pathogens and vectors have tended to develop as three separate fields of research. This artificial compartmentalisation is of concern due to our growing appreciation of the strong co-evolutionary interactions among hosts, pathogens and vectors. Infection, Genetics and Evolution and its companion congress [MEEGID](http://www.meegidconference.com/) (for Molecular Epidemiology and Evolutionary Genetics of Infectious Diseases) are the main forum acting for the cross-fertilization between evolutionary science and biomedical research on infectious diseases. Infection, Genetics and Evolution is the only journal that welcomes articles dealing with the genetics and evolutionary biology of hosts, pathogens and vectors, and coevolution processes among them in relation to infection and disease manifestation. All infectious models enter the scope of the journal, including pathogens of humans, animals and plants, either parasites, fungi, bacteria, viruses or prions. The journal welcomes articles dealing with genetics, population genetics, genomics, postgenomics, gene expression, evolutionary biology, population dynamics, mathematical modeling and bioinformatics. We also provide many author benefits, such as free PDFs, a liberal copyright policy, special discounts on Elsevier publications and much more. Please click here for more information on our author services .