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

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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.

Keywords: Mycobacterium tuberculosis; RDRio; clinical features; epidemiology; lineage

Document Type: Research Article

Affiliations: 1: Multidisciplinary Research Laboratory, Clementino Fraga Filho University Hospital, Institute of Thoracic Diseases, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil 2: Laboratory of Applied Molecular Biology to Mycobacteria, Oswaldo Cruz Institute, Rio de Janeiro, Rio de Janeiro, Brazil 3: Tuberculosis Control Program, Clementino Fraga Filho University Hospital, Institute of Thoracic Diseases, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil 4: Mycobacteriology Laboratory, Instituto de Microbiologia, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil 5: Tuberculosis Academic Program, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil 6: Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University, New York, New York, USA; and Centers for Disease Control in Haiti, Dulles, Virginia, USA

Publication date: 01 October 2012

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