ArticlePLoS medicine2022
Phylogeography and transmission of M. tuberculosis in Moldova: A prospective genomic analysis.
Article in PLoS medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 54 citations in OpenAlex.
- Long-term spatiotemporal evolution of drug-resistant Mycobacterium tuberculosis in China.Nature communications · 2026Article
- Multidrug-Resistant Tuberculosis in Central and Eastern Europe: Implementation and Maturity of Whole-Genome Sequencing for Surveillance.Diseases (Basel, Switzerland) · 2026Review
- The global phylogeography of rapidly expanding multidrug resistant Ural lineage 4.2 Mycobacterium tuberculosis.Nature communications · 2026Article
- A tiled amplicon protocol for culture-free whole-genome sequencing ofJournal of clinical microbiology · 2026Article
- Extensive Endemic Transmission of Multidrug-ResistantOpen forum infectious diseases · 2026Article
- Evaluating selection at intermediate scales within genes provides robust identification of genes under positive selection in M. tuberculosis clinical isolates.Tuberculosis (Edinburgh, Scotland) · 2025Article
- Molecular Epidemiology of Mycobacterium tuberculosis Across 3 Distinct Geographic Sites in South Africa.The Journal of infectious diseases · 2025Article
- Characteristics of compensatory mutations in rifampicin-resistant tuberculosis and their association with compensated transmission in Ningbo, China.BMC microbiology · 2025Article
- Evaluating selection at intermediate scales within genes provides robust identification of genes under positive selection inbioRxiv : the preprint server for biology · 2025Article
- Integrating genomic and spatial analyses to describe tuberculosis transmission: a scoping review.The Lancet. Microbe · 2025Article
- A new method for detecting mixed Mycobacterium tuberculosis infection and reconstructing constituent strains provides insights into transmission.Genome medicine · 2025Article
- Classification of unsequenced Mycobacterium tuberculosis strains in a high-burden setting using a pairwise logistic regression approach.Access microbiology · 2025Article
- Distribution and transmission of M. tuberculosis in a high-HIV prevalence city in Malawi: A genomic and spatial analysis.PLOS global public health · 2025Article
- TGV: suite of tools to visualize transmission graphs.NAR genomics and bioinformatics · 2024Article
- Approaches forAmerican journal of respiratory and critical care medicine · 2024Article
- Reply to CohenAmerican journal of respiratory and critical care medicine · 2024Article
- Impact and cost-effectiveness of the 6-month BPaLM regimen for rifampicin-resistant tuberculosis in Moldova: A mathematical modeling analysis.PLoS medicine · 2024Article
- The recent rapid expansion of multidrug resistant Ural lineage Mycobacterium tuberculosis in Moldova.Nature communications · 2024Article
- The Recent Transmission and Associated Risk Factor ofInfection and drug resistance · 2024Article
- Discrepancy in the transmissibility of multidrug-resistantEmerging microbes & infections · 2023Article
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Authors and funding
21 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundThe incidence of multidrug-resistant tuberculosis (MDR-TB) remains critically high in countries of the former Soviet Union, where >20% of new cases and >50% of previously treated cases have resistance to rifampin and isoniazid. Transmission of resistant strains, as opposed to resistance selected through inadequate treatment of drug-susceptible tuberculosis (TB), is the main driver of incident MDR-TB in these countries. METHODS AND
findingsWe conducted a prospective, genomic analysis of all culture-positive TB cases diagnosed in 2018 and 2019 in the Republic of Moldova. We used phylogenetic methods to identify putative transmission clusters; spatial and demographic data were analyzed to further describe local transmission of Mycobacterium tuberculosis. Of 2,236 participants, 779 (36%) had MDR-TB, of whom 386 (50%) had never been treated previously for TB. Moreover, 92% of multidrug-resistant M. tuberculosis strains belonged to putative transmission clusters. Phylogenetic reconstruction identified 3 large clades that were comprised nearly uniformly of MDR-TB: 2 of these clades were of Beijing lineage, and 1 of Ural lineage, and each had additional distinct clade-specific second-line drug resistance mutations and geographic distributions. Spatial and temporal proximity between pairs of cases within a cluster was associated with greater genomic similarity. Our study lasted for only 2 years, a relatively short duration compared with the natural history of TB, and, thus, the ability to infer the full extent of transmission is limited.
conclusionsThe MDR-TB epidemic in Moldova is associated with the local transmission of multiple M. tuberculosis strains, including distinct clades of highly drug-resistant M. tuberculosis with varying geographic distributions and drug resistance profiles. This study demonstrates the role of comprehensive genomic surveillance for understanding the transmission of M. tuberculosis and highlights the urgency of interventions to interrupt transmission of highly drug-resistant M. tuberculosis.
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