4.3 Article

Tuberculosis caused by RDRio Mycobacterium tuberculosis is not associated with differential clinical features

Journal

Publisher

INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)
DOI: 10.5588/ijtld.11.0709

Keywords

Mycobacterium tuberculosis; lineage; RDRio; epidemiology; clinical features

Funding

  1. National Institutes for Health, USA [NIH R 21]
  2. Innovative Approaches for TB Control in Brazil [U2R TW006885]
  3. Projetos de Ensino e Extensao/Fundacao de Amparo a Pesquisa do Estado do Rio de Janeiro
  4. Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior/Conselho Nacional de Desenvolvimento Cientifico e Tecnologico, Ministry of Science and Technology, Brazil

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BACKGROUND: We recently described the Mycobacterium tuberculosis RDRio genotype, a clonally derived sublineage within the Latin American Mediterranean (LAM) family. Genetic diversity of M. tuberculosis likely affects the clinical aspects of tuberculosis (TB). Prospective studies that address this issue are scarce and remain controversial. OBJECTIVE: To determine the association of differential clinical features of pulmonary TB with the RDRio. M. tuberculosis etiology. METHODS: Culture-proven pulmonary TB patients (n = 272) were clinically evaluated, including history, physical examination, chest X-ray and anti-human immunodeficiency virus serology. Isolates were classified as RDRio or non-RDRio M. tuberculosis by multiplex polymerase chain reaction and further spoligotyped. Clinical and M. tuberculosis genotype data were analyzed. RESULTS: RDRio M. tuberculosis caused disease in 26.5% (72/270) of all TB cases. The LAM genotype, of which RDRio strains are members, was responsible for 46.0% of the TB cases. Demographic data, major signs and symptoms, radiographic presentation, microbiological features and clinical outcomes were not significantly different among patients with TB caused by RDRio and non-RDRio strains. CONCLUSIONS: Disease caused by M. tuberculosis RDRio strains was not clinically distinctive or more severe than disease caused by non-RDRio, strains in this series of TB patients. Larger prospective studies specifically designed to disclose differential clinical characteristics of TB caused by specific M. tuberculosis lineages are needed.

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