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      Tuberculosis Caused by Mycobacterium africanum, United States, 2004–2013

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          Abstract

          Routine reporting of TB caused by this organism does not appear warranted at this time.

          Abstract

          Mycobacterium africanum is endemic to West Africa and causes tuberculosis (TB). We reviewed reported cases of TB in the United States during 2004–2013 that had lineage assigned by genotype (spoligotype and mycobacterial interspersed repetitive unit variable number tandem repeats). M. africanum caused 315 (0.4%) of 73,290 TB cases with lineage assigned by genotype. TB caused by M. africanum was associated more with persons from West Africa (adjusted odds ratio [aOR] 253.8, 95% CI 59.9–1,076.1) and US-born black persons (aOR 5.7, 95% CI 1.2–25.9) than with US-born white persons. TB caused by M. africanum did not show differences in clinical characteristics when compared with TB caused by M. tuberculosis. Clustered cases defined as >2 cases in a county with identical 24-locus mycobacterial interspersed repetitive unit genotypes, were less likely for M. africanum (aOR 0.1, 95% CI 0.1–0.4), which suggests that M. africanum is not commonly transmitted in the United States.

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          Global phylogeography of Mycobacterium tuberculosis and implications for tuberculosis product development.

          Sebastien Gagneux, Peter Small (2007)
          New tools for controlling tuberculosis are urgently needed. Despite our emerging understanding of the biogeography of Mycobacterium tuberculosis, the implications for development of new diagnostics, drugs, and vaccines is unknown. M tuberculosis has a clonal genetic population structure that is geographically constrained. Evidence suggests strain-specific differences in virulence and immunogenicity in light of this global phylogeography. We propose a strain selection framework, based on robust phylogenetic markers, which will allow for systematic and comprehensive evaluation of new tools for tuberculosis control.
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            Progression to active tuberculosis, but not transmission, varies by Mycobacterium tuberculosis lineage in The Gambia.

            Martien Borgdorff, Maureen P Small, Timothy Awine … (2008)
            There is considerable variability in the outcome of Mycobacterium tuberculosis infection. We hypothesized that Mycobacterium africanum was less likely than M. tuberculosis to transmit and progress to tuberculosis disease. In a cohort study of patients with tuberculosis and their household contacts in The Gambia, we categorized 1808 HIV-negative tuberculosis contacts according to exposure to M. tuberculosis or M. africanum. Positive skin test results indicated transmission, and development of tuberculosis during 2 years of follow-up indicated progression to disease. Transmission rates were similar, but rates of progression to disease were significantly lower in contacts exposed to M. africanum than in those exposed to M. tuberculosis (1.0% vs. 2.9%; hazard ratio [HR], 3.1 [95% confidence interval {CI}, 1.1-8.7]). Within M. tuberculosis sensu stricto, contacts exposed to a Beijing family strain were most likely to progress to disease (5.6%; HR relative to M. africanum, 6.7 [95% CI, 2.0-22]). M. africanum and M. tuberculosis transmit equally well to household contacts, but contacts exposed to M. africanum are less likely to progress to tuberculosis disease than those exposed to M. tuberculosis. The variable rate of progression by lineage suggests that tuberculosis variability matters in clinical settings and should be accounted for in studies evaluating tuberculosis vaccines and treatment regimens for latent tuberculosis infection.
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              Mycobacterium africanum—Review of an Important Cause of Human Tuberculosis in West Africa

              Bouke de Jong, Martin Antonio, Sebastien Gagneux (2010)
              Mycobacterium africanum consists of two phylogenetically distinct lineages within the Mycobacterium tuberculosis complex, known as M. africanum West African 1 and M. africanum West African 2. These lineages are restricted to West Africa, where they cause up to half of human pulmonary tuberculosis. In this review we discuss the definition of M. africanum, describe the prevalence and restricted geographical distribution of M. africanum West African 1 and 2, review the occurrence of M. africanum in animals, and summarize the phenotypic differences described thus far between M. africanum and M. tuberculosis sensu stricto.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): March 2016
                Volume: 22
                Issue: 3
                Pages: 396-403
                Affiliations
                [1]Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA
                Author notes
                Address for correspondence: Aditya Sharma, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop E10, Atlanta, GA 30329-4027, USA; e-mail: asharma4@ 123456cdc.gov
                Article
                Publisher ID: 15-1505
                DOI: 10.3201/eid2203.151505
                PMC ID: 4766873
                PubMed ID: 26886258
                SO-VID: 24ab9b76-ab72-4d1c-b60b-33e56a93a48f
                History
                Categories
                Subject: Synopsis
                Subject: Synopsis
                Subject: Tuberculosis Caused by Mycobacterium africanum, United States, 2004–2013

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: mycobacterium africanum,bacteria,tuberculosis and other mycobacteria,surveillance,genotype,united states
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: mycobacterium africanum, bacteria, tuberculosis and other mycobacteria, surveillance, genotype, united states

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