Genetic diversity of Mycobacterium tuberculosis isolates from northwest of Iran during Covid-19 era

ABSTRACT

Tuberculosis (TB) is considered one of the most infectious diseases in the world. In this study, we intended to examine the epidemiology of tuberculosis by MIRU-VNTR to define the changes that occur in the transmission of tuberculosis in the region during the COVID-19 era. A total of 120 Mycobacterium tuberculosis isolates were collected from sputum samples of patients referred to East Azerbaijan Center TB from December 2020 to August 2021. Demographic information such as age, sex, place of birth, previous TB history, and relevant medical data was collected. The drug susceptibility testing was performed by the proportion method and the PCR-based MIRU-VNTR method was applied to identify molecular epidemiology relationships. The isolates were collected from 78 males (52%) and 72 females (48%) Iranian patients and 6 (4%) Azerbaijani patients. 120 distinct patterns were identified including 15 clustered patterns and 36 unique patterns. The largest cluster was composed of seven isolates. Furthermore,1 cluster with 7 isolates, 1 cluster with 5 members, 4 clusters with 3 members, and 9 clusters with 2 members. In MIRU-VNTR typing, 75 clusters belonged to Tabriz and just 3 clusters belonged to Azerbaijan. All isolates were sensitive to rifampin, isoniazid and ethambutol. Results of the current study showed COVID-19 pandemic had a direct effect on the transmission and diagnosis of tuberculosis. Less diagnosis and less clustering can indicate public controls and hygiene and the use of masks had a direct effect on the transmission and diagnosis of tuberculosis. However, misidentification and less focus on other respiratory infections are expected during the pandemic. Studies on co-infection of COVID-19 and tuberculosis and the role of mask and sanitization against TB are strongly recommended.