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Title: Indo-Oceanic Mycobacterium tuberculosis strains from Thailand associated with higher mortality
Authors: N. Smittipat
R. Miyahara
T. Juthayothin
P. Billamas
K. Dokladda
W. Imsanguan
D. Intralawan
K. Rukseree
S. Jaitrong
B. Chaiyasirinroje
J. Wongjai
A. Disratthakit
A. Chaiprasert
S. Nedsuwan
S. Mahasirimongkol
L. Toyo-Oka
K. Tokunaga
N. Yamada
P. Palittapongarnpim
H. Yanai
Japan Anti-Tuberculosis Association
University of Tokyo
Thailand Ministry of Public Health
Mahidol University
Thailand National Center for Genetic Engineering and Biotechnology
Faculty of Medicine, Siriraj Hospital, Mahidol University
The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association
Medical Life Sciences Institute
TB/HIV Research Foundation
Keywords: Medicine
Issue Date: 1-Sep-2019
Citation: International Journal of Tuberculosis and Lung Disease. Vol.23, No.9 (2019), 972-979
Abstract: © 2019 The Union. SETTING: This study was conducted among tuberculosis (TB) patients in a highly endemic Thai province. OBJECTIVE : To evaluate the association between different Mycobacterium tuberculosis lineages and clinical characteristics, especially mortality. DESIGN: We enrolled 1,304 TB patients registered from 2002-2011 with culture isolates whose lineages were identified by specific regions of deletion. Data on mortality within 1 year of follow-up were extracted from the registration system and hospital records. Mortality-associated risk factors, including bacterial lineages, as independent variables were analysed using Cox regression models. RESULT S : Of 1,304 isolates, 521 (40.0%) and 582 (44.6%) belonged to Indo-Oceanic and East-Asian lineages, respectively. Indo-Oceanic strains significantly increased the mortality risk compared with East-Asian strains (adjusted hazard ratio [aHR] 1.42, 95%CI 1.02- 1.99) or modern lineages (aHR 1.49, 95%CI 1.08-2.06) in the 172 patients who died within 1 year after TB diagnosis. The former also caused significantly higher mortality than modern lineages among patients who died within 6 months after TB diagnosis (aHR 1.62, 95%CI 1.12-2.35). No significant association was found between drug resistance and death. CONCLUS ION: In Thailand, the Indo-Oceanic lineage of M. tuberculosis increased mortality risk compared with modern lineages or the East-Asian lineage, the latter being considered highly virulent in previous studies.
ISSN: 18157920
Appears in Collections:Scopus 2019

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