EmergingMycobacterium bovisin Lebanon: a snapshot based on whole-genome sequencing

Abstract

ABSTRACTBackgroundTuberculosis is a pressing public health issue in Lebanon, a country of approximately five million people, including around 1.5 million refugees from Palestine and Syria. Prior research has revealed uncontrolled animal sources ofMycobacterium bovis, emphasizing the necessity for a comprehensive approach to combat tuberculosis in the region.Methods48 clinicalMycobacterium tuberculosiscomplex isolates were identified through whole genome sequence. Also, 43 animal fecal samples were collected from various farms across Lebanon to investigate the presence of theM. tuberculosiscomplex using CRISPR-csm4 PCR.ResultsGenomic analysis revealed that 39/48 (81.25%) of isolates wereM. tuberculosisand 9/48 (18.75%) wereM. bovis. M. tuberculosiswas distributed over four lineages, Indo-Oceanic L1 (n = 3/39)(7.6%), East-Asian L2 (n = 1/39)(2.5%), East-African Indian L3 (n = 5/39)(12.8%) and Euro-American L4 (n = 30/39)(76.9%). Sub-lineage L4.8 (Euro-American (mainly T), comprising 8/39 of the isolates (20.5%) was predominant, followed by sub-lineages L3 (East-African Indian, n = 5/39 isolates)(12.8%), L4.2.2.2 (Euro-American (Ural), n= 4/39 isolates)(10.2%) and L4.6.5 (Euro American, n=4/39 isolates)(10.2%). NineM. boviswere classified into two clades, designated as unknown2 (n=2/9; 22.2%) and unknown3 (n=7/9; 77.8%). Interestingly, none of the clades or others were detected in the 48 faecal samples using CRISPR standard PCR and qPCR.ConclusionsThis study offers insights into human and bovine tuberculosis in Lebanon, emphasizingM. tuberculosislineages prevalence andM. bovisdistribution into two clades, aiding the fight against tuberculosis, especially bovine tuberculosis, and renewing our understanding of tuberculosis dynamics in Lebanon.