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Volume 31, Number 3—March 2025
Dispatch

Outbreak Caused by Multidrug-Resistant Mycobacterium Tuberculosis with Unusual Combination of Resistance Mutations, Northern Argentina, 2006–2022

Roxana Paul1, Federico Lorenzo1, Beatriz López, María Gabriela Alegre, David Couvin, Nalin Rastogi, Laura Pérez-Lago, Darío García de Viedma, Ana Gamberale, Norma González, Domingo Palmero, Silvia Altabe, Norberto Simboli, and Noemí Kaoru YokoboriComments to Author 
Author affiliation: Author affiliations: Instituto Nacional de Enfermedades Infecciosas, ANLIS “Dr. C. G. Malbrán,” Buenos Aires, Argentina (R. Paul, F. Lorenzo, B. López, N. Simboli, N.K. Yokobori); Programa de Control de Tuberculosis, Chaco, Argentina (M.G. Alegre, S. Altabe); Université des Antilles, Guadeloupe, France (D. Couvin); Institut Pasteur de Guadeloupe, Abymes, Guadeloupe (D. Couvin, N. Rastogi); Hospital General Universitario Gregorio Marañón, Madrid, Spain (L. Pérez-Lago, D. García de Viedma); Instituto de Investigaciòn Sanitaria Gregorio Marañón, Madrid (L. Pérez-Lago, D. García de Viedma); Instituto de Salud Carlos III, Madrid (D. García de Viedma); Hospital Muñiz, Buenos Aires (A. Gamberale, D. Palmero); Instituto Vaccarezza, Buenos Aires (A. Gamberale, D. Palmero); Hospital General de Niños “Pedro de Elizalde,” Buenos Aires (N. González); National Scientific and Technical Research Council, Buenos Aires (N.K. Yokobori)

Main Article

Figure 2

Schematic representations of the timeline and epidemiologic links of the MDR Mycobacterium tuberculosis outbreak with strain Ch, Chaco, Argentina, 2006–2022. Two subclusters were defined according to the phylogenetic analysis (Figure 1). The symbols represent epidemiologic events. Patients represented with squares were identified as part of the outbreak after comprehensive epidemiologic research in the light of the genomic results (Appendix 2). They had received a clinical diagnosis, and the drug susceptibility profiles were not available. Dot colors represent the drug-resistance status and the mutation found. The exact date of the events indicated with a question mark is unknown. Black arrow indicates administration of bedaquiline to patient 10, and the red arrow indicates implementation of phenotypic drug-susceptibility testing for that drug in Argentina. MDR, multidrug resistant; WGS NA, whole-genome sequence not available; XDR, extensively multidrug resistant.

Figure 2. Schematic representations of the timeline and epidemiologic links of the MDR Mycobacterium tuberculosis outbreak with strain Ch, Chaco, Argentina, 2006–2022. Two subclusters were defined according to the phylogenetic analysis (Figure 1). The symbols represent epidemiologic events. Patients represented with squares were identified as part of the outbreak after comprehensive epidemiologic research in the light of the genomic results (Appendix 2). They had received a clinical diagnosis, and the drug susceptibility profiles were not available. Dot colors represent the drug-resistance status and the mutation found. The exact date of the events indicated with a question mark is unknown. Black arrow indicates administration of bedaquiline to patient 10, and the red arrow indicates implementation of phenotypic drug-susceptibility testing for that drug in Argentina. MDR, multidrug resistant; WGS NA, whole-genome sequence not available; XDR, extensively multidrug resistant.

Main Article

1These first authors contributed equally to this article.

Page created: February 04, 2025
Page updated: February 21, 2025
Page reviewed: February 21, 2025
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