Differences among sublineages of the East-Asian lineage of Mycobacterium tuberculosis in genotypic clustering.

ABSTRACT

SETTING: The East-Asian lineage of Mycobacterium tuberculosis is composed of five sublineages, and includes the strains from the Beijing spoligotype family. In some studies these strains were highly pathogenic, although other studies did not support this finding. OBJECTIVE: To determine if the sublineages of the East-Asian lineage of M. tuberculosis differ in their capacity to cause secondary cases, as assessed by genotypic clustering of isolates. DESIGN: In a population-based study of 545 patients with M. tuberculosis from the East-Asian lineage in San Francisco, we used DNA-based fingerprinting to identify genotypic clustering, which was compared among the different sublineages defined by large sequence polymorphism. RESULTS: Strains from sublineage 207 had the highest frequency of genotypic clustering. In the multivariate analysis, only patients born in the United States were associated with clustering. CONCLUSIONS: We found evidence in a univariate analysis that the different East-Asian sublineages of M. tuberculosis have different frequencies of genotypic clustering. The effect size for this difference was unchanged in multivariate analysis, although loss of observations due to missing data resulted in a non-significant P value. It is tantalizing to hypothesize that the different East-Asian sublineages may differ in their capacity to cause secondary cases.