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Jugheli, L.

Publications and source records attributed to Jugheli, L..

4 recordsLinked to original sources

Within-host evolution of drug tolerance in Mycobacterium tuberculosis.

SynopsisO_ST_ABSBackgroundC_ST_ABSMycobacterium tuberculosis (Mtb) causes tuberculosis (TB) in humans. Poor treatment responses are a threat to global TB control, as such, understanding contributing factors to poor responses is important. We hypothesized that antibiotic tolerance could contribute to delayed culture conversion (recalcitrant TB), and resistance amplification in patients during TB treatment. ObjectivesTo investigate the role of drug tolerance in delayed culture conversion and resistance amplification in TB patients. MethodsWe collected serial Mtb isolates from i) patients with drug-susceptible TB who remained culture positive for up to 6 years (i.e. recalcitrant TB), and ii) patients with multidrug-resistant TB (MDR-TB) where resistance amplified during treatment. We measured tolerance to rifampicin (RIF) in drug-susceptible TB strains and tolerance to moxifloxacin (MFX) in MDR-TB strains using a real-time time-kill assay. ResultsRIF tolerance evolved within-host, increasing up to and ~1.5-fold, however, there was no apparent contribution of RIF tolerance to delayed culture conversion. Tolerance to Mfx in MDR-TB patients appeared negatively associated with resistance amplification and consistently decreased over time in patients. ConclusionOur findings confirm that antibiotic tolerance evolves in Mtb within patients over time during treatment. However, there was no evidence that this tolerance influences treatment responses, calling for further investigation of contributors to adverse treatment responses and their mitigation.

microbiology↗

Drug-induced differential culturability in diverse strains of Mycobacterium tuberculosis.

Differential culturable bacteria grow in liquid culture medium but are unable to form colonies on solid medium. Differentially culturable Mycobacterium tuberculosis (Mtb) bacteria, have been found in tuberculosis (TB) patient sputa. We hypothesized that antibiotic treatment can induce differential culturability in Mtb. We investigated the effect of exposure to TB drugs on Mtb culturability using clinical samples from an ongoing TB patient cohort and by conducting several in vitro experiments with a diverse set of Mtb strains. In patients, serial sputa were more likely to generate Mtb-positive cultures in liquid as opposed to solid medium, with this liquid culture bias extending up to 5 months post diagnosis. Experimentally, there was a disparity between bacterial time to positivity (TTP) and colony forming units (CFUs) when Mtb was exposed to isoniazid (INH) and rifampicin (RIF) alone or in combination. Cultures recovered from RIF treatment yielded more CFUs on agar plates, but INH-treated cultures had a faster TTP in liquid. Follow up experiments using a fluorescently labelled laboratory strain of Mtb revealed that CFUs overestimated killing by INH treatment. Here we provide evidence in Mtb that drug exposure affects culturability on solid medium, which has implications for treatment monitoring and drug-pathogen interaction studies.

microbiology↗

Local adaptation in populations of Mycobacterium tuberculosis endemic to the Indian Ocean Rim

Lineage 1 (L1) and 3 (L3) are two lineages of the Mycobacterium tuberculosis complex (MTBC), causing tuberculosis (TB) in humans. L1 and L3 are endemic to the Rim of the Indian Ocean, the region that accounts for most of the worlds new TB cases. Despite their relevance for this region, L1 and L3 remain understudied. Here we analyzed 2,938 L1 and 2,030 L3 whole genome sequences originating from 69 countries. We show that South Asia played a central role in the dispersion of these two lineages to neighboring regions. Moreover, we found that L1 exhibits signatures of local adaptation at the esxH locus, a gene coding for a secreted effector that targets the human endosomal sorting complex, and is included in several vaccine candidates. Our study highlights the importance of genetic diversity in the MTBC, and sheds new light on two of the most important MTBC lineages affecting humans.

genomics↗

Multiple Introductions of the Mycobacterium tuberculosis Lineage 2 Beijing into Africa over centuries

The Lineage 2-Beijing (L2-Beijing) sub-lineage of Mycobacterium tuberculosis has received much attention due to its high virulence, fast disease progression, and association with antibiotic resistance. Despite several reports of the recent emergence of L2-Beijing in Africa, no study has investigated the evolutionary history of this sub-lineage on the continent. In this study, we used whole genome sequences of 817 L2 clinical strains from 14 geographical regions globally distributed to investigate the origins and onward spread of this lineage in Africa. Our results reveal multiple introductions of L2-Beijing into Africa linked to independent bacterial populations from East-and Southeast Asia. Bayesian analyses further indicate that these introductions occurred during the past 300 years, with most of these events pre-dating the antibiotic era. Hence, the success of L2-Beijing in Africa is most likely due to its hypervirulence and high transmissibility rather than drug resistance.

evolutionary biology↗