Four decades of transmission of a multidrug-resistant Mycobacterium tuberculosis outbreak strain

• Autores: Eldholm, Vegard; Monteserin, Johana; Rieux, Adrien; López, Beatriz; Sobkowiak, Benjamin; Ritacco, Viviana; Balloux, Francois
• Año de publicación: 2015
• Idioma: inglés
• Tipo de recurso: artículo
• Fuente: Nature Communications 2015; 6:7119
• Materia: Antituberculosos; Argentina; Proteínas Bacterianas; Brotes de Enfermedades; Regulación Bacteriana de la Expresión Génica; Humanos; Pruebas de Sensibilidad Microbiana; Mycobacterium tuberculosis; Filogenia; Polimorfismo de Nucleótido Simple; Regiones Promotoras Genéticas; Factores de Tiempo; Tuberculosis Resistente a Múltiples Medicamentos
• Institución: Administración Nacional de Laboratorios e Institutos de Salud "Dr. Carlos G. Malbrán"

Fil: Eldholm, Vegard. Norwegian Institute of Public Health. Division of Infectious Disease Control; Noruega.
Fil: Monteserin, Johana. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.
Fil: Rieux, Adrien. University College London. Department of Genetics, Evolution and Environment; Reino Unido.
Fil: López, Beatriz. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.
Fil: Sobkowiak, Benjamin. University College London. Department of Genetics, Evolution and Environment; Reino Unido.
Fil: Ritacco, Viviana. ANLIS Dr.C.G.Malbrán. Instituto Nacional de Enfermedades Infecciosas; Argentina.
Fil: Balloux, Francois. University College London. Department of Genetics, Evolution and Environment; Reino Unido.
The rise of drug-resistant strains is a major challenge to containing the tuberculosis (TB) pandemic. Yet, little is known about the extent of resistance in early years of chemotherapy and when transmission of resistant strains on a larger scale became a major public health issue. Here we reconstruct the timeline of the acquisition of antimicrobial resistance during a major ongoing outbreak of multidrug-resistant TB in Argentina. We estimate that the progenitor of the outbreak strain acquired resistance to isoniazid, streptomycin and rifampicin by around 1973, indicating continuous circulation of a multidrug-resistant TB strain for four decades. By around 1979 the strain had acquired additional resistance to three more drugs. Our results indicate that Mycobacterium tuberculosis (Mtb) with extensive resistance profiles circulated 15 years before the outbreak was detected, and about one decade before the earliest documented transmission of Mtb strains with such extensive resistance profiles globally.