Changes in the molecular genetic structure of Mycobacterium tuberculosis in Republic Sakha (Yakutia) in 2009–2024: spread of Beijing B0/W148 subtype

Introduction. In the Republic of Sakha (Yakutia) since 2020, the incidence of tuberculosis (TB) has become lower than the Russian average against the background of an increase in the proportion of multidrug-resistant (MDR) strains of Mycobacterium tuberculosis, including among new cases.

Objective. To analyze the changes in the molecular genetic structure of M. tuberculosis strains for 2009–2024.

Materials and methods. We studied 669 strains for 2009–2014 (first period) and 2022– 2024 (second period) by RD 207/105/181, SNPand MIRU-VNTR 24 typing methods.

Results. The primary MDR (without pre-XDR and XDR) were 22.2 % and 24.6 % by periods, the pre-XDR increased from 1.0 % to 16.9 % and XDR strains were emergence in 3.3 % in 2022–2024. In the second period, the Beijing genotype was predominance (67.3 % vs. 43.3 % in the first period; p < 0.001), Beijing Central Asian Russian was increased from 21.7 % to 31.0 % (p = 0.006), Beijing B0/W148 was increased from 14.9 to 34.0 % (p < 0.001). Euro-American lineage was represented by endemic for Sakha (Yakutia) S genotype (13.8 % and 18.0 % by periods), genotypes T, LAM, Ural, H. In all age groups in the second period, an increase in the proportion of Beijing B0/W148 was found. The pre-XDR profiles of B0/W148 were increased (53,9 % vs 7,3 %; p < 0,001) and was found XDR (6.9 %). For genotype S, the primary pre-XDR (33,3 % vs 5,7 %; p = 0,002) was increased and XDR was found in 44.4 %.

Conclusion. In the period of 2022–2024, in the M. tuberculosis population, a high level of pre-XDR and XDR in Beijing B0/W148 strains (60.8 %), and S genotype (60.1 %) was detected. Beijing B0/W148 strains have spread and influence MDR amplification, as the endemic S genotype, which requires further surveillance and control.

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