Open AccessRD Rio Mycobacterium tuberculosis Infection Is Associated with a Higher Frequency of Cavitary Pulmonary Disease
Author(s) -
Luiz Claudio Oliveira Lazzarini,
Silvana Miranda Spindola,
Heejung Bang,
Andrea L. Gibson,
Scott A. Weisenberg,
Wânia da Silva Carvalho,
Cláudio José Augusto,
Richard C. Huard,
Afrânio Lineu Kritski,
John L. Ho
Publication year - 2008
Publication title -
journal of clinical microbiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.349
H-Index - 255
eISSN - 1070-633X
pISSN - 0095-1137
DOI - 10.1128/jcm.00065-08
Subject(s) - tuberculosis , mycobacterium tuberculosis , medicine , sputum , genotyping , transmission (telecommunications) , mycobacterium tuberculosis complex , disease , immunology , genotype , biology , pathology , electrical engineering , gene , engineering , biochemistry
Molecular genotyping has shownMycobacterium tuberculosis lineages to be geographically restricted and associated with distinct ethnic populations. Whether tuberculosis (TB) caused by someM. tuberculosis lineages can present with a differential clinical spectrum is controversial because of very limited clinical data. We recently reported on the discovery of RDRio M. tuberculosis , a Latin American-Mediterranean sublineage that is the predominant cause of TB in Rio de Janeiro, Brazil. To investigate the clinical attributes of TB caused by RDRio strains, we studied a cohort of TB cases from Belo Horizonte, Brazil, in which clinical information recorded on a standardized questionnaire was collected at the time of microbiological testing. These patients were referred for culture and drug susceptibility testing because of the clinical suspicion of “complicated” TB, as demonstrated by high rates of multidrug resistance (12%) and cavitary TB (80%). We performed spoligotyping and RDRio genotyping on theM. tuberculosis strains and analyzed the clinical data from these patients. RDRio M. tuberculosis accounted for 37% of the total TB burden. Multivariate analysis found a significant association between TB caused by RDRio strains and pulmonary cavitation and residence in Belo Horizonte. Since cavitary TB is associated with higher sputum bacillary load, our findings support the hypothesis that RDRio M. tuberculosis is associated with a more “severe” disease as a strategy to increase transmission. Future studies are needed to confirm these observations and to better define the contribution of RDRio M. tuberculosis to the global TB epidemic.