Cross-Border Movement of Highly Drug-Resistant Mycobacterium tuberculosis from Papua New Guinea to Australia through Torres Strait Protected Zone, 2010-2015

Emerg Infect Dis. 2019 Mar;25(3):406-415. doi: 10.3201/eid2503.181003.

Abstract

In this retrospective study, we used whole-genome sequencing (WGS) to delineate transmission dynamics, characterize drug-resistance markers, and identify risk factors of transmission among Papua New Guinea residents of the Torres Strait Protected Zone (TSPZ) who had tuberculosis diagnoses during 2010-2015. Of 117 isolates collected, we could acquire WGS data for 100; 79 were Beijing sublineage 2.2.1.1, which was associated with active transmission (odds ratio 6.190, 95% CI 2.221-18.077). Strains were distributed widely throughout the TSPZ. Clustering occurred more often within than between villages (p = 0.0013). Including 4 multidrug-resistant tuberculosis isolates from Australia citizens epidemiologically linked to the TSPZ into the transmission network analysis revealed 2 probable cross-border transmission events. All multidrug-resistant isolates (33/104) belonged to Beijing sublineage 2.2.1.1 and had high-level isoniazid and ethionamide co-resistance; 2 isolates were extensively drug resistant. Including WGS in regional surveillance could improve tuberculosis transmission tracking and control strategies within the TSPZ.

Keywords: Australia; Beijing sublineage 2.2.1.1; MDR TB; Mycobacterium tuberculosis; Papua New Guinea; TB; Torres Strait; antimicrobial resistance; bacteria; cross-border movement; drug resistance; ethionamide; isoniazid; mycobacteria; transmission; tuberculosis; tuberculosis and other mycobacteria; whole-genome sequencing.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antitubercular Agents / pharmacology
  • Australia / epidemiology
  • Bacterial Typing Techniques
  • Emigration and Immigration*
  • Evolution, Molecular
  • Genotype
  • Geography
  • History, 21st Century
  • Humans
  • Microbial Sensitivity Tests
  • Mycobacterium tuberculosis / drug effects*
  • Mycobacterium tuberculosis / genetics
  • Mycobacterium tuberculosis / isolation & purification
  • Papua New Guinea / epidemiology
  • Tuberculosis, Multidrug-Resistant / diagnosis
  • Tuberculosis, Multidrug-Resistant / epidemiology*
  • Tuberculosis, Multidrug-Resistant / history
  • Tuberculosis, Multidrug-Resistant / microbiology*
  • Whole Genome Sequencing

Substances

  • Antitubercular Agents