Hyper transmission of Beijing lineage Mycobacterium tuberculosis: Systematic review and meta-analysis

Malancha Karmakar; James M Trauer; David B Ascher; Justin T Denholm

doi:10.1016/j.jinf.2019.09.016

Hyper transmission of Beijing lineage Mycobacterium tuberculosis: Systematic review and meta-analysis

J Infect. 2019 Dec;79(6):572-581. doi: 10.1016/j.jinf.2019.09.016. Epub 2019 Oct 1.

Authors

Malancha Karmakar¹, James M Trauer², David B Ascher³, Justin T Denholm⁴

Affiliations

¹ Victorian Tuberculosis Program, Melbourne Health, 792 Elizabeth Street, Melbourne, Victorian 3000 Australia; Department of Biochemistry and Molecular Biology, Bio21 Institute, University of Melbourne, Melbourne, Victoria 3010, Australia; Department of Microbiology and Immunology, at the Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia; Structural Biology and Bioinformatics, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
² Victorian Tuberculosis Program, Melbourne Health, 792 Elizabeth Street, Melbourne, Victorian 3000 Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
³ Department of Biochemistry and Molecular Biology, Bio21 Institute, University of Melbourne, Melbourne, Victoria 3010, Australia; Structural Biology and Bioinformatics, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Department of Biochemistry, University of Cambridge, CB2 1GA, UK.
⁴ Victorian Tuberculosis Program, Melbourne Health, 792 Elizabeth Street, Melbourne, Victorian 3000 Australia; Department of Microbiology and Immunology, at the Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia. Electronic address: Justin.denholm@mh.org.au.

PMID: 31585190
DOI: 10.1016/j.jinf.2019.09.016

Abstract

Objectives: The globally distributed "Beijing" lineage of Mycobacterium tuberculosis has been associated with outbreaks worldwide. Laboratory based studies have suggested that Beijing lineage may have increased fitness; however, it has not been established whether these differences are of epidemiological significance with regards to transmission. Therefore, we undertook a systematic review of epidemiological studies of tuberculosis clustering to compare the transmission dynamics of Beijing lineages versus the non-Beijing lineages.

Methods: We systematically searched Embase and MEDLINE before 31st December 2018, for studies which provided information on the transmission dynamics of the different M. tuberculosis lineages. We included articles that conducted population-based cross-sectional or longitudinal molecular epidemiological studies reporting information about extent of transmission of different lineages. The protocol for this systematic review was prospectively registered with PROSPERO (CDR42018088579).

Results: Of 2855 records identified by the search, 46 were included in the review, containing 42,700 patients from 27 countries. Beijing lineage was the most prevalent and highly clustered strain in 72.4% of the studies and had a higher likelihood of transmission than non-Beijing lineages (OR 1·81 [95% 1·28-2·57], I² = 94·0%, τ² = 0·59, p < 0·01).

Conclusions: Despite considerable heterogeneity across epidemiological contexts, Beijing lineage appears to be more transmissible than other lineages.

Keywords: Beijing lineage; Molecular genotyping; Transmission; Tuberculosis.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cluster Analysis
Disease Transmission, Infectious*
Female
Global Health
Humans
Infant
Infant, Newborn
Male
Middle Aged
Mycobacterium tuberculosis / classification*
Mycobacterium tuberculosis / isolation & purification*
Prevalence
Tuberculosis / epidemiology
Tuberculosis / microbiology*
Tuberculosis / transmission*
Young Adult