New insights on tuberculosis transmission dynamics and drug susceptibility profiles among the prison population in Southern Brazil based on whole-genome sequencing

Author(s):Show less -

Lívia Maria Pala Anselmo ^[1] ; Juliana Failde Gallo ^[2] ; Juliana Maira Watanabe Pinhata ^[3] ; Kamila Chagas Peronni ^[4] ; Wilson Araújo da Silva Junior ^[5] ; Patricia de Cássia Ruy ^[6] ; Emilyn Costa Conceição ^[7] ; Anzaan Dippenaar ^[8] ; Robin Mark Warren ^[9] ; Aline Aparecida Monroe ^[10] ; Rosangela Siqueira Oliveira ^[11] ; Valdes Roberto Bollela ^[12]

Affiliation:Show less -

^[1] Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Clínica Médica - Brasil

^[2] Instituto Adolfo Lutz. Núcleo de Tuberculose e Micobacterioses. Centro de Bacteriologia - Brasil

^[3] Instituto Adolfo Lutz. Núcleo de Tuberculose e Micobacterioses. Centro de Bacteriologia - Brasil

^[4] Instituto para Pesquisa do Câncer - Brasil

^[5] Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Genética - Brasil

^[6] Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Centro de Medicina Genômica do Hospital das Clínicas - Brasil

^[7] Stellenbosch University. National Research Foundation Centre of Excellence for Biomedical Tuberculosis Research. Department of Science and Innovation - África do Sul

^[8] University of Antwerp. Faculty of Medicine and Health Sciences. Family Medicine and Population Health (FAMPOP) - Bélgica

^[9] Stellenbosch University. Faculty of Medicine and Health Sciences. Department of Science and Innovation - África do Sul

^[10] Universidade de São Paulo. Escola de Enfermagem de Ribeirão Preto (EERP-USP) - Brasil

^[11] Instituto Adolfo Lutz. Núcleo de Tuberculose e Micobacterioses. Centro de Bacteriologia - Brasil

^[12] Universidade de São Paulo. Faculdade de Medicina de Ribeirão Preto. Departamento de Clínica Médica - Brasil

• Document type: Journal article
• Source: Revista da Sociedade Brasileira de Medicina Tropical; v. 56, 2023-02-20.

Abstract

ABSTRACT Background: The rate of tuberculosis (TB) infection among the prison population (PP) in Brazil is 28 times higher than that in the general population, and prison environment favors the spread of TB. Objective: To describe TB transmission dynamics and drug resistance profiles in PP using whole-genome sequencing (WGS). Methods: This was a retrospective study of Mycobacterium tuberculosis cultivated from people incarcerated in 55 prisons between 2016 and 2019; only one isolate per prisoner was included. Information about movement from one prison to another was tracked. Clinical information was collected, and WGS was performed on isolates obtained at the time of TB diagnosis. Results: Among 134 prisoners included in the study, we detected 16 clusters with a total of 58 (43%) cases of M. tuberculosis. Clusters ranged from two to seven isolates with five or fewer single nucleotide polymorphism (SNP) differences, suggesting a recent transmission. Six (4.4%) isolates were resistant to at least one anti-TB drug. Two of these clustered together and showed resistance to rifampicin, isoniazid, and fluoroquinolones, with 100% concordance between WGS and phenotypic drug-susceptibility testing. Prisoners with clustered isolates had a high amount of movement between prisons (two to eight moves) during the study period. Conclusions: WGS demonstrated the recent transmission of TB within prisons in Brazil. The high movement among prisoners seems to be related to the transmission of the same M. tuberculosis strain within the prison system. Screening for TB before and after the movement of prisoners using rapid molecular tests could play a role in reducing transmission. (AU)

• FAPESP's process: 18/07341-1 - Evaluation of tuberculosis dynamics transmission among incarcerated people using whole genome sequencing of Mycobacterium tuberculosis.
• Grantee: Valdes Roberto Bollela
• Support Opportunities: Regular Research Grants