ArticleBMC infectious diseases2022
Evolution and spread of a highly drug resistant strain of Mycobacterium tuberculosis in Papua New Guinea.
Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 23 citations in OpenAlex.
- Predicting isoniazid resistance inJournal of clinical microbiology · 2026Article
- Investigation of bedaquiline heteroresistance amongMicrobiology spectrum · 2025Article
- TB programme outcomes in South Fly District, Papua New Guinea, were maintained through COVID-19.Public health action · 2024Article
- Drug-resistant TB in Morobe Province, Papua New Guinea, 2012-2021.Public health action · 2024Article
- Operational research highlights ongoing challenges for comprehensive TB services in Papua New Guinea.Public health action · 2024Article
- Loss to follow-up among adults with drug-resistant TB in Papua New Guinea.Public health action · 2024Article
- Exploring optimal drug targets through subtractive proteomics analysis and pangenomic insights for tailored drug design in tuberculosis.Scientific reports · 2024Article
- Global burden of MDR-TB and XDR-TB attributable to high fasting plasma glucose from 1990 to 2019: a retrospective analysis based on the global burden of disease study 2019.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Loss-of-function mutations inAntimicrobial agents and chemotherapy · 2024Article
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- Whole-Genome Sequencing to PredictAntibiotics (Basel, Switzerland) · 2023Article
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundMolecular mechanisms determining the transmission and prevalence of drug resistant tuberculosis (DR-TB) in Papua New Guinea (PNG) are poorly understood. We used genomic and drug susceptibility data to explore the evolutionary history, temporal acquisition of resistance and transmission dynamics of DR-TB across PNG.
methodsWe performed whole genome sequencing on isolates from Central Public Health Laboratory, PNG, collected 2017-2019. Data analysis was done on a composite dataset that also included 100 genomes previously sequenced from Daru, PNG (2012-2015).
resultsSampled isolates represented 14 of the 22 PNG provinces, the majority (66/94; 70%) came from the National Capital District (NCD). In the composite dataset, 91% of strains were Beijing 2.2.1.1, identified in 13 provinces. Phylogenetic tree of Beijing strains revealed two clades, Daru dominant clade (A) and NCD dominant clade (B). Multi-drug resistance (MDR) was repeatedly and independently acquired, with the first MDR cases in both clades noted to have emerged in the early 1990s, while fluoroquinolone resistance emerged in 2009 (95% highest posterior density 2000-2016). We identified the presence of a frameshift mutation within Rv0678 (p.Asp47fs) which has been suggested to confer resistance to bedaquiline, despite no known exposure to the drug. Overall genomic clustering was significantly associated with rpoC compensatory and inhA promoter mutations (p < 0.001), with high percentage of most genomic clusters (12/14) identified in NCD, reflecting its role as a potential national amplifier.
conclusionsThe acquisition and evolution of drug resistance among the major clades of Beijing strain threaten the success of DR-TB treatment in PNG. With continued transmission of this strain in PNG, genotypic drug resistance surveillance using whole genome sequencing is essential for improved public health response to outbreaks. With occurrence of resistance to newer drugs such as bedaquiline, knowledge of full drug resistance profiles will be important for optimal treatment selection.
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