The recent rapid expansion of multidrug resistant Ural lineage Mycobacterium tuberculosis in Moldova

Melanie H. Chitwood (), Caroline Colijn, Chongguang Yang, Valeriu Crudu, Nelly Ciobanu, Alexandru Codreanu, Jaehee Kim, Isabel Rancu, Kyu Rhee, Ted Cohen () and Benjamin Sobkowiak
Additional contact information
Melanie H. Chitwood: 60 College Street
Caroline Colijn: 8888 University Drive West
Chongguang Yang: Guangzhou University Town Guangdong
Valeriu Crudu: Strada Constantin Vârnav 13
Nelly Ciobanu: Strada Constantin Vârnav 13
Alexandru Codreanu: Strada Constantin Vârnav 13
Jaehee Kim: 237 Tower Road
Isabel Rancu: 60 College Street
Kyu Rhee: 1300 York Ave
Ted Cohen: 60 College Street
Benjamin Sobkowiak: 60 College Street

Nature Communications, 2024, vol. 15, issue 1, 1-9

Abstract: Abstract The projected trajectory of multidrug resistant tuberculosis (MDR-TB) epidemics depends on the reproductive fitness of circulating strains of MDR M. tuberculosis (Mtb). Previous efforts to characterize the fitness of MDR Mtb have found that Mtb strains of the Beijing sublineage (Lineage 2.2.1) may be more prone to develop resistance and retain fitness in the presence of resistance-conferring mutations than other lineages. Using Mtb genome sequences from all culture-positive cases collected over two years in Moldova, we estimate the fitness of Ural (Lineage 4.2) and Beijing strains, the two lineages in which MDR is concentrated in the country. We estimate that the fitness of MDR Ural strains substantially exceeds that of other susceptible and MDR strains, and we identify several mutations specific to these MDR Ural strains. Our findings suggest that MDR Ural Mtb has been transmitting efficiently in Moldova and poses a substantial risk of spreading further in the region.

Date: 2024
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DOI: 10.1038/s41467-024-47282-9

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