Emerging Infectious Diseases (Mar 2019)

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

  • Arnold Bainomugisa,
  • Sushil Pandey,
  • Ellen Donnan,
  • Graham Simpson,
  • J’Belle Foster,
  • Evelyn Lavu,
  • Stenard Hiasihri,
  • Emma S. McBryde,
  • Rendi Moke,
  • Steven Vincent,
  • Vitali Sintchenko,
  • Ben J. Marais,
  • Lachlan J.M. Coin,
  • Christopher Coulter

DOI
https://doi.org/10.3201/eid2503.181003
Journal volume & issue
Vol. 25, no. 3
pp. 406 – 415

Abstract

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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.

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