|754-1||First insight into molecular epidemiology of Mycobacterium tuberculosis in Santa Catarina State, Southern Brazil|
|Autores:||Christiane Lourenço Nogueira (UFSC - Universidade Federal de Santa Catarina) ; Simone Gonçalves Senna (UFSC - Universidade Federal de Santa Catarina) ; Rosemeri Maurici da Silva (UNISUL - Universidade do Sul de Santa Catarina / UFSC - Universidade Federal de Santa Catarina) ; Darcita Rovares Buerger (LACEN/SC - Laboratório Central de Saúde Pública de Santa Catarina) ; Maria Lúcia Rossetti (FEPPS/RS - Fundação Estadual de Produção e Pesquisa em Saúde) ; Maria Luiza Bazzo (UFSC - Universidade Federal de Santa Catarina) |
Although Tuberculosis (TB) is a preventable and treatable disease, it remains one of the leading infectious diseases worldwide. Santa Catarina has one of the lowest incidence rates in the country (27.6/100,000), but some cities, like Itajai (77.3/100,000), have alarming incidence rates. Since data about M. tuberculosis circulating strains in SC is scarce, we genotyped 406 clinical isolates (2010-2011) using Spoligotyping. The demographic and clinical data were collected from the national Information System for Notifiable Diseases. Among all cases, about 70% lived in Itajai Valley or Florianópolis Metropolitan Area. Caucasians (81%), young adults (74%), males (72%) and low education level (70%) were the predominant profiles found. About 50% had some condition associated with TB, from which 23.1% were co-infected with HIV, 37.6% used excess alcohol and 35.2% used illicit drugs. Eighty percent were new cases and association was found between treatment dropout (9%) and alcoholism (p=0,022) and drug addiction (p<0,001). Pulmonary TB was predominant (89%) and an association of extrapulmonary TB and HIV (p<0,001) was detected. Six percent were MDR-TB, which was associated with drug addiction (p=0,005). The genotyping revealed LAM as the most frequent lineage (40.1%) followed by T (23.4%), Harleem (12.8%), U (3.7%), X (2.7%) and S (1.7%). LAM9 (20.0%), H3 (9.6%) and T2/T3 (8.4%) were the most frequently sublineages among all analyzed strains. The most frequent genotypes identified were very similar to those found in Portugal and Italy, which reflects the SC colonization. Some sublineages and SITs were found in a low incidence and were unexpected in South America and could represent genotypes due to migratory flux driven by Itajaí port city as well as the intense national/international tourism in SC. In addition, association was found between MDR-TB and H3 (LAM3?) (p=0,002) and Unk21 (p<0,001), as well as HIV coinfection and LAM9 (p=0,034) and T2-T3 (p=0,039) genotypes. Prisoners’ incarceration showed association with LAM5 (p=0,042), Unk4 (p=0,002), Unk7 (p=0,001) and Unk21 (p=0,005). Moreover some MDR isolates were found simultaneously in different penitentiaries, which represents an important public health problem. This study provided the first insight into molecular epidemiology of M. tuberculosis in Santa Catarina.
Palavras-chave: molecular epidemiology, tuberculosis, spoligotyping, genotyping