Skip to main content

ORIGINAL RESEARCH article

Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1442987

Genetic diversity and transmission pattern of multidrug-resistant tuberculosis based on whole-genome sequencing in Wuhan, China

Provisionally accepted
Qionghong Duan Qionghong Duan 1*LIQING WEI LIQING WEI 2Jun Chen Jun Chen 1Zhengbin Zhang Zhengbin Zhang 1zhen Deng zhen Deng 1Zefang Zhang Zefang Zhang 1
  • 1 Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, China
  • 2 Wuhan University, Wuhan, Hubei Province, China

The final, formatted version of the article will be published soon.

    Background: Investigating the molecular epidemiological characteristics of multidrug-resistant tuberculosis (MDR-TB) in China's moderate-burden regions, such as Wuhan, is crucial for understanding and controlling disease transmission. Materials and methods: This study analyzed MDR-TB isolates from pulmonary tuberculosis cases registered at Wuhan Pulmonary Hospital in 2017. Whole genome sequencing (WGS) was used to identify resistance-conferring mutations, examine their associations with specific Mycobacterium tuberculosis lineages or sublineages, and assess clustering profiles. Results: Among the 149 analyzed strains, the most prevalent mutations associated with resistance to 11 anti-tuberculosis drugs were identified as follows: rpoB Ser450Leu (59.73%, rifampicin), katG Ser315Thr (62.42%, isoniazid), embB Met306Val (42.86%, ethambutol), rpsL Lys43Arg (68.13%, streptomycin), pncA Trp68Arg (10.53%, pyrazinamide), gyrA Asp94Gly (22.50%, fluoroquinolones), and rrs 1401A>G (50.00%-100.00%, second-line injectable aminoglycosides). Additional mutations were detected in fabG1 c-15C>T (42.86%, ethionamide) and thyX c-16C>T (21.43%, p-aminosalicylic acid). Notably, rare mutations absent from the WHO mutation catalog, such as ahpC c-52C>T and rpsL Lys43Thr, were also observed. The mutation frequency of embB Met306Ile was significantly higher in Lineage 4 (L4) strains than in Lineage 2 (L2) strains (P = 0.0150), while the rpsL Lys43Arg mutation frequency was lower in L4 compared to L2 (P = 0.0333). A total of 31 MDR MTB Mycobacterium tuberculosis isolates formed clusters, resulting in a clustering rate of 20.81% and a recent transmission rate of 11.41%. The clustering rates between L4 and L2 strains were not significantly different (χ² = 0.0017, P > 0.05). Conclusion: The genetic diversity of MDR-TB in Wuhan demonstrates unique characteristics, with evidence of localized transmission. These findings highlight the urgent need to strengthen measures to detect early cases of MDR-TB and control transmission of MDR-TB in the region.

    Keywords: Whole-genome sequencing, genetic diversity, Transmission pattern, Wuhan, China, Multidrug-resistant tuberculosis

    Received: 03 Jun 2024; Accepted: 09 Jan 2025.

    Copyright: © 2025 Duan, WEI, Chen, Zhang, Deng and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Qionghong Duan, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.