Using new genomic surveillance techniques, Yale researchers have identified multidrug-resistant strains of Tuberculosis in Moldova.
The dissolution of the Soviet Union in the 1990s led to breakdowns in healthcare, infrastructure and reduced quality of life among its former constituents. The deteriorating healthcare conditions also led to an increase in cases of Tuberculosis (TB) in the regions. The Republic of Moldova, once part of the Soviet Union, is one of the most badly affected of all. It currently has one of the highest rates of multidrug-resistant tuberculosis cases in the world. However, the transmission of these pathogens remains unclear. Therefore, scientists at the Yale School of Public Health used new genome surveillance techniques to identify the spread of these strains in Moldova.
What is MDR-TB?
Multidrug-resistant tuberculosis (MDR-TB) is a form of tuberculosis that is resistant to isoniazid and rifampicin, the two first-line anti-TB drugs. Although it is treatable and curable with second-line drugs, those are often expensive and toxic. Moreover, at times the bacteria can develop more severe drug resistance, leaving patients helpless. Therefore, posing a serious threat to public health. In Moldova, the transmission of MDR-TB has mostly occurred due to the transmission of resistant strains rather than the misuse of anti-TB drugs. The study aimed to identify where the transmission was occurring, and the variants of MRD-Tb involved.
The team analyzed more than 2,000 TB-positive samples from 2018 to 2019. Results revealed three distinct drug-resistant strains in the country: 2 of Beijing lineage and 1 of Ural lineage. Moreover, clusters of each strain had different geographic distribution and drug resistance mutations.
Thus, the findings demonstrate the complex epidemiology of multidrug-resistant tuberculosis in Moldova. And further highlights the need for more efficient interventions to stop the spread.
Yang C, Sobkowiak B, Naidu V, Codreanu A, Ciobanu N, Gunasekera KS, et al. (2022) Phylogeography and transmission of M. tuberculosis in Moldova: A prospective genomic analysis. PLoS Med 19(2): e1003933. https://doi.org/10.1371/journal.pmed.1003933