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Volume 25, Number 3—March 2019
Dispatch

Longitudinal Outbreak of Multidrug-Resistant Tuberculosis in a Hospital Setting, Serbia

Irena Arandjelović1Comments to Author , Matthias Merker1, Elvira Richter, Thomas A. Kohl, Branislava Savić, Ivan Soldatović, Thierry Wirth, Dragana Vuković1, and Stefan Niemann1
Author affiliations: University of Belgrade, Belgrade, Serbia (I. Arandjelović, B. Savić, I. Soldatović, D. Vuković); Leibniz-Zentrum für Medizin und Biowissenschaften, Borstel, Germany (M. Merker, T.A. Kohl, S. Niemann); Laboratory Limbach, Heidelberg, Germany (E. Richter); Paris Sciences & Lettres University, Paris, France (T. Wirth); Sorbonne Universités, Paris (T. Wirth); German Center for Infection Research, Borstel, Germany (S. Niemann)

Main Article

Figure 1

Maximum-likelihood phylogeny, applying a general time-reversible substitution model, of 103 multidrug-resistant (MDR) Mycobacterium tuberculosis complex (MTBC) isolates from Serbia sampled during 2008–2014. Orange squares indicate MDR MTBC isolates associated with putative transmission chains (molecular clusters); gray squares indicate other MDR MTBC isolates. All analyzed strains belong to the major MTBC phylogenetic lineage 4 (Euro-American) or lineage 2 (Beijing); red text indicates lineage 4

Figure 1. Maximum-likelihood phylogeny, applying a general time-reversible substitution model, of 103 multidrug-resistant (MDR) Mycobacterium tuberculosis complex (MTBC) isolates from Serbia sampled during 2008–2014. Orange squares indicate MDR MTBC isolates associated with putative transmission chains (molecular clusters); gray squares indicate other MDR MTBC isolates. All analyzed strains belong to the major MTBC phylogenetic lineage 4 (Euro-American) or lineage 2 (Beijing); red text indicates lineage 4 and blue text, lineage 2. Subgroups are further named according to the single-nucleotide polymorphism barcode nomenclature from Coll et al. (5), and to the associated mycobacterial interspersed repetitive unit–variable-number tandem-repeat genotype classification (6). Subgroup-defining branches are labeled with bootstrap values based on 1,000 resamples.

Main Article

References
  1. World Health Organization. Global tuberculosis report. Contract no.: WHO/HTM/TB/2017.23. Geneva: The Organization; 2017.
  2. European Centre for Disease Prevention and Control; WHO Regional Office for Europe. Tuberculosis surveillance and monitoring in Europe 2017. Stockholm: European Centre for Disease Prevention and Control; 2017.
  3. Vuković  D, Rüsch-Gerdes  S, Savić  B, Niemann  S. Molecular epidemiology of pulmonary tuberculosis in belgrade, central serbia. J Clin Microbiol. 2003;41:43727. DOIPubMedGoogle Scholar
  4. Merker  M, Blin  C, Mona  S, Duforet-Frebourg  N, Lecher  S, Willery  E, et al. Evolutionary history and global spread of the Mycobacterium tuberculosis Beijing lineage. Nat Genet. 2015;47:2429. DOIPubMedGoogle Scholar
  5. Coll  F, McNerney  R, Guerra-Assunção  JA, Glynn  JR, Perdigão  J, Viveiros  M, et al. A robust SNP barcode for typing Mycobacterium tuberculosis complex strains. Nat Commun. 2014;5:4812. DOIPubMedGoogle Scholar
  6. Niemann  S, Merker  M, Kohl  T, Supply  P. Impact of genetic diversity on the biology of Mycobacterium tuberculosis complex strains. Microbiol Spectr. 2016;4:TBTB2-0022-2016.
  7. Comas  I, Borrell  S, Roetzer  A, Rose  G, Malla  B, Kato-Maeda  M, et al. Whole-genome sequencing of rifampicin-resistant Mycobacterium tuberculosis strains identifies compensatory mutations in RNA polymerase genes. Nat Genet. 2011;44:10610. DOIPubMedGoogle Scholar
  8. Jovanovic  D, Skodric-Trifunovic  V, Markovic-Denic  L, Stevic  R, Vlajinac  H. Clinical and epidemiological evaluation of tuberculosis in Serbia, 1990–2004. Int J Tuberc Lung Dis. 2007;11:64751.https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17519096&dopt=Abstract
  9. Pachi  A, Bratis  D, Moussas  G, Tselebis  A. Psychiatric morbidity and other factors affecting treatment adherence in pulmonary tuberculosis patients. Tuberc Res Treat. 2013;2013:489865.
  10. Tosevski  DL, Gajic  SD, Milovancevic  MP. Mental healthcare in Serbia. Int Psychiatry. 2010;7:135. DOIGoogle Scholar

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1These authors contributed equally to this article.

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