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A Major Mycobacterium tuberculosis outbreak caused by one specific genotype in a low-incidence country: Exploring gene profile virulence explanations

Denmark, a tuberculosis low burden country, still experiences significant active Mycobacterium tuberculosis (Mtb) transmission, especially with one specific genotype named Cluster 2/1112–15 (C2), the most prevalent lineage in Scandinavia. In addition to environmental factors, antibiotic resistance,...

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Published in:Scientific reports 2018-08, Vol.8 (1), p.11869-8, Article 11869
Main Authors: Folkvardsen, Dorte Bek, Norman, Anders, Andersen, Åse Bengård, Rasmussen, Erik Michael, Lillebaek, Troels, Jelsbak, Lars
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description Denmark, a tuberculosis low burden country, still experiences significant active Mycobacterium tuberculosis (Mtb) transmission, especially with one specific genotype named Cluster 2/1112–15 (C2), the most prevalent lineage in Scandinavia. In addition to environmental factors, antibiotic resistance, and human genetics, there is increasing evidence that Mtb strain variation plays a role for the outcome of infection and disease. In this study, we explore the reasons for the success of the C2 genotype by analysing strain specific polymorphisms identified through whole genome sequencing of all C2 isolates identified in Denmark between 1992 and 2014 (n = 952), and the demographic distribution of C2. Of 234 non-synonymous (NS) monomorphic SNPs found in C2 in comparison with Mtb reference strain H37Rv, 23 were in genes previously reported to be involved in Mtb virulence. Of these 23 SNPs, three were specific for C2 including a NS mutation in a gene associated with hyper-virulence. We show that the genotype is readily transmitted to different ethnicities and is also found outside Denmark. Our data suggest that strain specific virulence factor variations are important for the success of the C2 genotype. These factors, likely in combination with poor TB control, seem to be the main drivers of C2 success.
doi_str_mv 10.1038/s41598-018-30363-3
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subjects 45
45/23
631/326/41/2482
692/308/174
Antibiotic resistance
Denmark - epidemiology
Disease Outbreaks
Disease transmission
Environmental factors
Genetics
Genome, Bacterial - genetics
Genomes
Genotype
Humanities and Social Sciences
Humans
Incidence
multidisciplinary
Mycobacterium tuberculosis
Mycobacterium tuberculosis - genetics
Outbreaks
Phylogeny
Polymorphism, Single Nucleotide - genetics
Scandinavian and Nordic Countries - epidemiology
Science
Science (multidisciplinary)
Single-nucleotide polymorphism
Success
Tuberculosis
Tuberculosis - epidemiology
Tuberculosis - microbiology
Virulence - genetics
Virulence factors
Virulence Factors - genetics
Whole Genome Sequencing - methods
title A Major Mycobacterium tuberculosis outbreak caused by one specific genotype in a low-incidence country: Exploring gene profile virulence explanations
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