Evolution and success of the multi-drug resistant m. tuberculosis sit41 (lam7-tur) lineage
Mycobacterium tuberculosis (MTB) is the cause of tuberculosis (TB) in humans. Identification of the MTB lineage is of importance to tuberculosis control as it has shown that strain type may play a role in disease outcome, variation in vaccine efficacy and emergence of drug resistance. MTB strains of Beijing and Latin-American-Mediterranean (LAM) lineages were associated with hyper-transmissibility and drug resistance. In 2013 the European Center for Diseases Prevention and Control (ECDC) effectively lunched molecular surveillance of MDR TB at EU level. The typing of M. tuberculosis strains in Bulgaria confirmed strong association between MDR and SIT41 (LAM7-TUR) [SIT – Spoligo International Type] MTB lineage. Statistically 97% of the TB patients infected with drug sensitive SIT41 MTB strain develop MDR tuberculosis. SIT41 is marker genotype for MDR TB. Urgent measures are needed to control and limit the expansion of the SIT41 lineage. We aim to promote personalised treatment of tuberculosis based on the genotype lineage of the TB pathogen and reducing the TB multidrug-resistant burden. The project has two objectives. First: Application of the next-generation sequencing data for genotyping of M. tuberculosis strains based on SNP data for tracking the origins, evolution and success of the SIT41 (LAM7-TUR) lineage, and second: Development of rapid screening methodology to identify the SIT41 (LAM7-TUR) genotype including mutation analysis to first and second line tuberculostatics drug resistance. Objectives will be achieved by fostering radically new technologies, by exploring novel ideas for MTB genotyping and improvement of the classical TB treatment scheme.
The project is timely because it has relevance to the Work Program Horizon 2020 focus area: Personalising health and care. For the first time we will promote personalised treatment associated with specific MTB genotype. The proposal is in line with the EU Health Strategy, ECDC, WHO and other TB control programs.