Longitudinal Outbreak of Multidrug-Resistant Tuberculosis in a Hospital Setting, Serbia
Irena Arandjelović
1 , Matthias Merker
1, Elvira Richter, Thomas A. Kohl, Branislava Savić, Ivan Soldatović, Thierry Wirth, Dragana Vuković
1, and Stefan Niemann
1
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)
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Figure 2
Figure 2. Most likely temporal and spatial origin of Mycobacterium tuberculosis complex (MTBC) TUR genotype outbreak strains in Serbia. A) Location annotated time-scaled phylogeny (maximum clade credibility tree) derived from a Bayesian discrete trait phylogeographical analysis of 37 lineage 4.2.2.1 (TUR genotype) multidrug-resistant (MDR) MTBC isolates. Branches are color-coded according to the most likely place of infection, assuming a fast-progression hypothesis (Appendix 1). Branches are annotated with location probabilities; symbols represent acquisition of individual resistance-related mutations shared by all derived strains. B) Regional and countrywide spread of individual TUR genotype outbreak strains originating from Bela Crkva Hospital. Arrows indicate inferred location changes determined from the genealogy shown in panel A. Scale bar indicates nucleotide substitutions per site.
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