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Armed conflict and population displacement as drivers of the evolution and dispersal of Mycobacterium tuberculosis
Journal article   Open access   Peer reviewed

Armed conflict and population displacement as drivers of the evolution and dispersal of Mycobacterium tuberculosis

Vegard Eldholm, John H-O Pettersson, Ola B Brynildsrud, Andrew Kitchen, Erik Michael Rasmussen, Troels Lillebaek, Janne O Rønning, Valeriu Crudu, Anne Torunn Mengshoel, Nadia Debech, …
Proceedings of the National Academy of Sciences - PNAS, Vol.113(48), pp.13881-13886
11/29/2016
DOI: 10.1073/pnas.1611283113
PMCID: PMC5137683
PMID: 27872285
url
https://doi.org/10.1073/pnas.1611283113View
Published (Version of record) Open Access

Abstract

The "Beijing" Mycobacterium tuberculosis (Mtb) lineage 2 (L2) is spreading globally and has been associated with accelerated disease progression and increased antibiotic resistance. Here we performed a phylodynamic reconstruction of one of the L2 sublineages, the central Asian clade (CAC), which has recently spread to western Europe. We find that recent historical events have contributed to the evolution and dispersal of the CAC. Our timing estimates indicate that the clade was likely introduced to Afghanistan during the 1979-1989 Soviet-Afghan war and spread further after population displacement in the wake of the American invasion in 2001. We also find that drug resistance mutations accumulated on a massive scale in Mtb isolates from former Soviet republics after the fall of the Soviet Union, a pattern that was not observed in CAC isolates from Afghanistan. Our results underscore the detrimental effects of political instability and population displacement on tuberculosis control and demonstrate the power of phylodynamic methods in exploring bacterial evolution in space and time.
Afghanistan - epidemiology Armed Conflicts Drug Resistance, Bacterial - genetics Europe Evolution, Molecular Genotype Humans Mycobacterium tuberculosis - drug effects Mycobacterium tuberculosis - genetics Mycobacterium tuberculosis - pathogenicity Phylogeny Tuberculosis - epidemiology Tuberculosis - genetics Tuberculosis - microbiology Tuberculosis - prevention & control United States - epidemiology USSR - epidemiology

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