Molecular diagnosis of childhood tuberculosis and infection with Bacilli Calmette-Guerin in Taiwan

Molecular techniques along with clinical evaluation have been demonstrated to be effective for differentiating childhood tuberculosis (TB), and for establishing an enhanced survey of adverse reactions of Bacilli Calmette-Guerin vaccination in Taiwan. Future development and evaluation of new diagnostics should be prioritized in strengthening the management of childhood TB

Human Tuberculosis Caused by Mycobacterium bovis, Taiwan

Human Tuberculosis Caused by Mycobacterium bovis, Taiwa

Extensively Drug-Resistant Tuberculosis,Taiwan

Extensively Drug-Resistant Tuberculosis, Taiwa

European 1 : a globally important clonal complex of Mycobacterium bovis

We have identified a globally important clonal complex of Mycobacterium bovis by deletion analysis of over one thousand strains from over 30 countries. We initially show that over 99% of the strains of M. bovis, the cause of bovine tuberculosis, isolated from cattle in the Republic of Ireland and the UK are closely related and are members of a single clonal complex marked by the deletion of chromosomal region RDEu1 and we named this clonal complex European 1 (Eu1). Eu1 strains were present at less than 14% of French, Portuguese and Spanish isolates of M. bovis but are rare in other mainland European countries and Iran. However, strains of the Eu1 clonal complex were found at high frequency in former trading partners of the UK (USA, South Africa, New Zealand, Australia and Canada). The Americas, with the exception of Brazil, are dominated by the Eu1 clonal complex which was at high frequency in Argentina, Chile, Ecuador and Mexico as well as North America. Eu1 was rare or absent in the African countries surveyed except South Africa. A small sample of strains from Taiwan were non-Eu1 but, surprisingly, isolates from Korea and Kazakhstan were members of the Eu1 clonal complex. The simplest explanation for much of the current distribution of the Eu1 clonal complex is that it was spread in infected cattle, such as Herefords, from the UK to former trading partners, although there is evidence of secondary dispersion since. This is the first identification of a globally dispersed clonal complex M. bovis and indicates that much of the current global distribution of this important veterinary pathogen has resulted from relatively recent International trade in cattle.This work was funded by: TBadapt project (LSHp-CT-2007-037919); B.M. received financial support from the Swiss National Science Foundation; Swedish Research Council, Swedish Heart-Lung foundation, Swedish International Development Agency; Department of Agriculture and Rural Development Northern Ireland (project DARD0407); EU project TB-STEP (KBBE-2007-1-3-04, no. 212414); Swiss National Science Foundation (Grant No. 107559); Damien Foundation, Belgium; Commission Universitaire pour le Développement (CUD), University of Liege (Project PIC); The Wellcome Trust Livestock for Life and Animal Health in the Developing World initiatives (075833/A/04/Z); Chilean National Livestock Service -FONDOSAGC5-100-10-23 and CONICYT-FIC-R-EQU18 and by the Department of Environment, Food and Rural Affairs, UK (project SB4020).http://www.elsevier.com/locate/meegidab2012ab2013 (Author correction

The 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: a genotypic analysis.

Background: Molecular diagnostics are considered the most promising route to achievement of rapid, universal drug susceptibility testing for Mycobacterium tuberculosis complex (MTBC). We aimed to generate a WHO-endorsed catalogue of mutations to serve as a global standard for interpreting molecular information for drug resistance prediction. Methods: In this systematic analysis, we used a candidate gene approach to identify mutations associated with resistance or consistent with susceptibility for 13 WHO-endorsed antituberculosis drugs. We collected existing worldwide MTBC whole-genome sequencing data and phenotypic data from academic groups and consortia, reference laboratories, public health organisations, and published literature. We categorised phenotypes as follows: methods and critical concentrations currently endorsed by WHO (category 1); critical concentrations previously endorsed by WHO for those methods (category 2); methods or critical concentrations not currently endorsed by WHO (category 3). For each mutation, we used a contingency table of binary phenotypes and presence or absence of the mutation to compute positive predictive value, and we used Fisher's exact tests to generate odds ratios and Benjamini-Hochberg corrected p values. Mutations were graded as associated with resistance if present in at least five isolates, if the odds ratio was more than 1 with a statistically significant corrected p value, and if the lower bound of the 95% CI on the positive predictive value for phenotypic resistance was greater than 25%. A series of expert rules were applied for final confidence grading of each mutation. Findings: We analysed 41 137 MTBC isolates with phenotypic and whole-genome sequencing data from 45 countries. 38 215 MTBC isolates passed quality control steps and were included in the final analysis. 15 667 associations were computed for 13 211 unique mutations linked to one or more drugs. 1149 (7·3%) of 15 667 mutations were classified as associated with phenotypic resistance and 107 (0·7%) were deemed consistent with susceptibility. For rifampicin, isoniazid, ethambutol, fluoroquinolones, and streptomycin, the mutations' pooled sensitivity was more than 80%. Specificity was over 95% for all drugs except ethionamide (91·4%), moxifloxacin (91·6%) and ethambutol (93·3%). Only two resistance mutations were identified for bedaquiline, delamanid, clofazimine, and linezolid as prevalence of phenotypic resistance was low for these drugs. Interpretation: We present the first WHO-endorsed catalogue of molecular targets for MTBC drug susceptibility testing, which is intended to provide a global standard for resistance interpretation. The existence of this catalogue should encourage the implementation of molecular diagnostics by national tuberculosis programmes. Funding: Unitaid, Wellcome Trust, UK Medical Research Council, and Bill and Melinda Gates Foundation

Identification of Beijing Lineage Mycobacterium tuberculosis with Combined Mycobacterial Interspersed Repetitive Unit Loci 26, 31, and ETR-A

A rapid method for identification of Beijing lineage Mycobacterium tuberculosis is still needed in regions of tuberculosis endemicity, especially if genotyping methods are not readily accessible. After analyzing 1,557 clinical isolates, a PCR method with combined mycobacterial interspersed repetitive unit loci 26, 31, and ETR-A for differentiation of Beijing lineage isolates was established, the sensitivity and specificity of which are 94.7% and 98.5%, respectively