10.22025/CAMSTAG2.54413
Poonawala, Husain
Kumar, Narender
Peacock, Sharon J
A review of published spoligotype data indicates the diversity of Mycobacterium tuberculosis from India is under-represented in global databases.
Apollo - University of Cambridge Repository (staging)
2019
India
Mycobacterium tuberculosis
Spoligotype
Strain diversity
Apollo - University of Cambridge Repository (staging)
Apollo - University of Cambridge Repository (staging)
2019-12-04
2019-12-04
2019-10-13
2019-05-20
2019-12-04
Article
https://dspace-staging.lib.cam.ac.uk/handle/1810/307145
1567-7257
31618692
S1567-1348(19)30298-9
10.1016/j.meegid.2019.104072
Mycobacterium tuberculosis (MTB) lineages differ in clinical presentation, virulence, transmission, drug resistance and immunological responses. Here, we review the published spoligotype data to determine the distribution and diversity of MTB lineages in India, which has the largest burden of TB in the world. A Pubmed/MEDLINE search identified 34 M. tuberculosis spoligotyping studies from India. Spoligotype patterns were extracted and the Spoligotype International Type (SIT) number, sub-lineage and lineage determined. Minimum Spanning Trees were used to determine relationships between patterns. We identified 1528 spoligotype patterns distributed across 8300 isolates; 6733 isolates belonged to 472 SITs, 12 of which predominated and contained 53% of all isolates. Lineage 1 and Lineage 3 made up 67% of all isolates, although a lineage could not be assigned for 16% of isolates. Lineage 1 isolates were most common in Southern, Western and Eastern India, and Lineage 3 was most common in Northern and Central India. The RULE, CBN and KBBN algorithms from the TB-lineage tools performed variably, with only 64% of all patterns predicted correctly. Using a consensus definition, 64% of the 1359 isolates with unknown lineage were assigned to Lineage 1, and 14% each were assigned to Lineages 3 and 4. With these lineage assignments, 80% of all isolates belonged to either Lineage 1 or Lineage 3. Our findings indicate significant M. tuberculosis diversity in India. The documentation of 1056 orphan and unreported patterns indicate that this diversity is under-represented in global databases. [Abstract copyright: Copyright © 2018. Published by Elsevier B.V.]