Genomic epidemiology analysis of extremely drug-resistant tuberculosis in Shanghai, China

作者：Xiaoyu Lu, Yuan Jiang, Yan Liu, Junhong Chen, Yinglin Lao, Jing Li, Yangyi Zhang, Nan Li, Lili Wang, Chenlei Yu, Ye Qi, Wei Wei, Jiale Deng, Xin Shen, Chongguang Yang · 发表于：Emerging Microbes & Infections · 年份：2025 · DOI：10.1080/22221751.2025.2521842 · 被引用次数：3 · 研究领域：Tuberculosis Research and Epidemiology、Mycobacterium research and diagnosis、Diagnosis and treatment of tuberculosis

Tuberculosis (TB), particularly extremely drug-resistant TB (EDR-TB), remains a significant public health concern worldwide. Understanding the transmission patterns and epidemiological characteristics of EDR-TB is vital for effective disease control. Between January 1, 2006, and December 31, 2018, we collected clinical M. tuberculosis strains in Shanghai, with whole-genome sequencing performed on 58 identified clinical EDR-TB strains. We analyzed EDR-related genetic mutations, conducted phylogenetic analyses, and examined bacterial and epidemiological factors that influence their transmission. Among these 58 EDR patients, 43.1% (25/58) were aged 45 to 64 years, with a median age of 51 years (interquartile range, IQR, 29–59 years). About two-thirds of the EDR-TB patients were residents. We observed a clustering rate of 44.8% (26/58) among EDR strains. Logistic regression analysis indicated a higher risk of recent EDR-TB transmission among the strains with the drug-resistant compensatory mutations. The primary mode of EDR-TB transmission in the study setting was recent, direct person-to-person spread of drug-resistant strains, as evidenced by high clustering rates and the presence of identical resistance mutations among clustered cases.