Molecular genetic structure of Mycobacterium tuberculosis in Krasnoyarsk region

Introduction. Despite the improvement of the general epidemiological situation for tuberculosis (TB) in Krasnoyarsk region, the spread of multiple and pre-extensive drug resistance (MDR and pre-XDR) of the pathogen remains a serious problem that requires a comprehensive analysis of factors, including an assessment of the circulating population of Mycobacterium tuberculosis.

Objective. To assess the molecular genetic structure of M. tuberculosis strains in Krasnoyarsk region.

Materials and methods. A total of 400 strains were studied for 2024 using SNPand MIRU-VNTR-24 typing.

Results. High levels of MDR (64.5 %), including pre-XDR (45.0 %) and XDR (1.5 %), were detected in the sample of M. tuberculosis strains. The dominance of L2 (Beijing genotype) was found in newly diagnosed cases (72.1 %) and previously treated patients (85.6 %). Non-Beijing strains belonged to the L4 genotypes (LAM, Ural, Haarlem and S). The most common Beijing subtypes were B0/W148 (49.5 %; 198/400) and Central Asian Russian (25.0 %; 99/400), they differed significantly in MDR levels (96.5 % and 36.4 %, respectively, by subtype; p < 0.001). Beijing B0/W148 strains had the highest levels of preXDR (71.7 %) and XDR (3.0 %). MDR among L4 strains (30.1 %) was significantly lower compared to Beijing (76.4 %) (p < 0.001). Strains from HIV-TB patients were more common with an MDR profile (74.4 %) than from patients without HIV infection (60.4 %) (p = 0.008) against the background of a higher presence of Beijing B0/W148 in the HIVTB group (59.8 % versus 45.2 %; p = 0.008).

Conclusion. Beijing B0/W148 strains account for about half of the study sample and make a significant contribution to the pre-XDR (78.9 %) and XDR (100 %), which requires further monitoring and enhanced control of treatment effectiveness.

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