TY - JOUR
T1 - Detection of M. tuberculosis in the environment as a tool for identifying high-risk locations for tuberculosis transmission
AU - Verma, Renu
AU - Moreira, Flora Martinez Figueira
AU - do Prado Morais, Agne Oliveira
AU - Walter, Katharine S.
AU - dos Santos, Paulo C. sar Pereira
AU - Kim, Eugene
AU - Soares, Thiego Ramon
AU - de Araujo, Rafaele Carla Pivetta
AU - da Silva, Bruna Oliveira
AU - da Silva Santos, Andrea
AU - Croda, Julio
AU - Andrews, Jason R.
N1 - Funding Information: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jason R. Andrews reports financial support was provided by National Institutes of Health. Funding Information: We thank the prison staff for their support and incarcerated individuals from prisons Penitenciária Estadual de Dourados (PED) and Estabelecimento Penal Jair Ferreira de Carvalho (EPJFC), Brazil for collecting ES swabs from their cells. We also thank Leonardo Martinez from Boston University for his support. This study was supported by NIH DP2 AI131082 and NIH AI130058. Funding Information: This study was supported by NIH DP2 AI131082 and NIH AI130058 . Publisher Copyright: © 2022 The Authors
PY - 2022/10/15
Y1 - 2022/10/15
N2 - Tuberculosis (TB) remains a leading cause of infectious mortality globally, yet most cases cannot be epidemiologically linked even with extensive contact investigations and whole genome sequencing. Consequently, there remain major gaps in our understanding of where and when M. tuberculosis (Mtb) exposures occur. We aimed to investigate whether Mtb can be detected in environments where TB patients were recently present, which could serve as a tool for characterizing exposure risk. We collected 389 environment surface (ES) swabs from two high TB burden prisons in Brazil, sampling 41 (n = 340) cells occupied by individuals with active TB and 7 (n = 49) cells from individuals without TB. In a subset of pooled swabs (n = 6) and a swab from a cigarette lighter from the cell with active TB patients, we enriched Mtb DNA using RNA-bait hybrid capture assays and performed whole genome sequencing. In prison cells, Mtb DNA was detected in 55/340 (16 %) of ES swabs from cells occupied by active TB patients and none (0/49) from cells in which no active TB patients were present. Mtb was detected in 13/16 (81 %) prison cells occupied by the individuals with high/medium sputum Xpert Mtb load and 8/25 (32 %) with low/very low sputum Mtb load (p = 0.003). Seven hybrid capture samples had a median genomic coverage of 140×. rpoB mutations conferring high-level rifampin resistance were detected in 3/7 ES swabs. Mtb was frequently detectable in environments recently occupied by individuals with active TB. This approach could be applied in congregate environments to identify and characterize high-risk settings for Mtb exposure.
AB - Tuberculosis (TB) remains a leading cause of infectious mortality globally, yet most cases cannot be epidemiologically linked even with extensive contact investigations and whole genome sequencing. Consequently, there remain major gaps in our understanding of where and when M. tuberculosis (Mtb) exposures occur. We aimed to investigate whether Mtb can be detected in environments where TB patients were recently present, which could serve as a tool for characterizing exposure risk. We collected 389 environment surface (ES) swabs from two high TB burden prisons in Brazil, sampling 41 (n = 340) cells occupied by individuals with active TB and 7 (n = 49) cells from individuals without TB. In a subset of pooled swabs (n = 6) and a swab from a cigarette lighter from the cell with active TB patients, we enriched Mtb DNA using RNA-bait hybrid capture assays and performed whole genome sequencing. In prison cells, Mtb DNA was detected in 55/340 (16 %) of ES swabs from cells occupied by active TB patients and none (0/49) from cells in which no active TB patients were present. Mtb was detected in 13/16 (81 %) prison cells occupied by the individuals with high/medium sputum Xpert Mtb load and 8/25 (32 %) with low/very low sputum Mtb load (p = 0.003). Seven hybrid capture samples had a median genomic coverage of 140×. rpoB mutations conferring high-level rifampin resistance were detected in 3/7 ES swabs. Mtb was frequently detectable in environments recently occupied by individuals with active TB. This approach could be applied in congregate environments to identify and characterize high-risk settings for Mtb exposure.
KW - Environment
KW - Mycobacterium tuberculosis
KW - Transmission
KW - Whole genome sequencing
UR - http://www.scopus.com/inward/record.url?scp=85133495230&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.scitotenv.2022.156970
DO - https://doi.org/10.1016/j.scitotenv.2022.156970
M3 - Article
C2 - 35760168
SN - 0048-9697
VL - 843
JO - Science of the total environment
JF - Science of the total environment
M1 - 156970
ER -