Transmission of drug-resistant Mycobacterium tuberculosis isolates between Finnish- and foreign-born patients, 2014-2021: a molecular epidemiological study

Author:

Zhu Jiahui1,Haanpera Marjo2,Mentula Silja2,Vapalahti Olli3,Soini Hanna2,Sironen Tarja3,Kant Ravi4,Zakham Fathiah3

Affiliation:

1. Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland

2. Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland

3. Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland; Department of Virology, University of Helsinki, Helsinki, Finland

4. Department of Veterinary Biosciences, University of Helsinki, Helsinki, Finland; Department of Virology, University of Helsinki, Helsinki, Finland; Department of Tropical Parasitology, Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdynia, Poland

Abstract

Abstract Background Data on the molecular epidemiological characteristics and transmission of drug-resistant Mycobacterium tuberculosis (MTB) isolates in low-incidence settings with immigration from high-incidence settings are limited.Method We included 101 drug-resistant MTB isolates with whole-genome sequencing data isolated in Finland between 2014 and 2021. Mutations associated with resistance to first- and second-line drugs were identified. Potential transmission clusters were identified using a threshold of 12 single-nucleotide polymorphisms (SNPs). Highly related clusters were identified using a threshold of 5 SNPs.Result Of the 101 drug-resistant MTB isolates, 29 (28.7%) isolates were from Finnish-born persons and 72 (71.3%) were from foreign-born persons. The proportion of foreign-born persons with multidrug-resistant (MDR) MTB (25/72, 34.7%) was higher than that in Finnish-born persons (6/29, 20.7%). The most common mutation associated with resistance to INH and RIF was katG Ser315Thr (67/83, 80.7%) and rpoB Ser450Leu (29/35, 82.9%), respectively. Lineage 4 (36/101, 35.6%) and lineage 2 (35/101, 34.6%) were prevalent lineages. A total of 16 (15.8%) isolates were classified into 7 potential transmission clusters (≤ 12 SNPs). Furthermore, one highly related cluster (≤ 5 SNPs) was identified, including one MDR isolate from a Finnish-born person and another MDR isolate from a person born in eastern Europe.Conclusion Transmission of drug-resistant MTB isolates between native and foreign-born persons is limited in Finland. Monitoring transmission dynamics of drug-resistant TB is of importance to inform tuberculosis management and control in low-incidence settings with increasing immigration.

Publisher

Research Square Platform LLC

Reference28 articles.

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2. Multidrug-resistant tuberculosis in Europe, 2010–2011;Gunther G;Emerg Infect Dis,2015

3. European Centre for Disease Prevention and Control WROfE. Tuberculosis surveillance and monitoring in Europe 2023–2021 data, 2023.

4. Multidrug-resistant tuberculosis in Norway: a nationwide study, 1995–2014;Jensenius M;Int J Tuberc Lung Dis,2016

5. Transmission of multidrug-resistant tuberculosis in a low-incidence setting, Switzerland, 2006 to 2012;Somoskovi AHP;Euro Surveill,2014

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