Publication date: Jun 23, 2025
Tuberculosis (TB), particularly extremely drug-resistant TB (EDR-TB), remains a significant public health concern worldwide. Understanding the transmission patterns and epidemiological characteristics of EDR-TB is vital for effective disease control. Between January 1, 2006, and December 31, 2018, we collected clinical M. tuberculosis strains in Shanghai, with whole-genome sequencing performed on 58 identified clinical EDR-TB strains. We analyzed EDR-related genetic mutations, conducted phylogenetic analyses, and examined bacterial and epidemiological factors that influence their transmission. Among these 58 EDR patients, 43. 1% (25/58) were aged 45 to 64 years, with a median age of 51 years (interquartile range, IQR, 29-59 years). About two-thirds of the EDR-TB patients were residents. We observed a clustering rate of 44. 8% (26/58) among EDR strains. Logistic regression analysis indicated a higher risk of recent EDR-TB transmission among the strains with the drug-resistant compensatory mutations. The primary mode of EDR-TB transmission in the study setting was recent, direct person-to-person spread of drug-resistant strains, as evidenced by high clustering rates and the presence of identical resistance mutations among clustered cases.
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| Concepts | Keywords |
|---|---|
| China | compensatory mutations |
| Genetic | EDR-TB |
| Tuberculosis | transmission |
| Worldwide | Whole-genome sequencing |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | extremely drug-resistant tuberculosis |
| disease | MESH | Tuberculosis |
| pathway | KEGG | Tuberculosis |
| disease | MESH | Infections |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | AIDS |
| drug | DRUGBANK | Spinosad |
| disease | IDO | drug susceptibility |
| drug | DRUGBANK | Dihydrostreptomycin |
| disease | MESH | treatment failure |
| disease | MESH | death |
| disease | MESH | community transmission |
| disease | IDO | bacteria |
| drug | DRUGBANK | Bedaquiline |
| drug | DRUGBANK | Linezolid |
| disease | MESH | privacy |
| drug | DRUGBANK | Guanosine |
| drug | DRUGBANK | Delamanid |
| disease | IDO | infection |
| drug | DRUGBANK | Rifampicin |
| disease | MESH | Infectious diseases |
| disease | IDO | history |
| disease | IDO | symptom |
| drug | DRUGBANK | Trestolone |
| disease | IDO | contact tracing |