Association of Mycobacterium tuberculosis genotypes and clinical and epidemiological features - a multi-center study in Taiwan.

Genotypes of Mycobacterium tuberculosis (MTB) are related to the geographic origin of the patients and population migration. The relationship between genotypes of MTB and clinical presentations has mainly focused on transmission of multi-drug resistant MTB strain in population. This study aimed to investigate the molecular epidemiology and dynamic change of MTB genotypes in Taiwan, and their association with clinical presentation among patients with pulmonary tuberculosis. A multi-center, two-year study which enrolled 516 patients with 516 MTB isolates was conducted, including: (1) 254 isolates from northern Taiwan; (2) 38 isolates from mid-western Taiwan; (3) 211 isolates from southern Taiwan; and (4) 13 isolates from the east coast of Taiwan. The isolates were genotyped with spoligotyping and standardized 12-loci-MIRU-VNTR method. The results showed Beijing/Beijing-like family was the major genotype of MTB in the northern (58%), eastern (53%), and southern (33%) regions. The second most widely spread lineage were the EAI-Manila (20% in the west and south) and Haarlem family (13-27% in the south, west, and east). According to the cluster analysis of 12-MIRU-VNTR genotypes, there were differences in distribution of MTB genotype between the northern and southern regions, and a temporal relationship between isolation year and 12-MIRU-VNTR genotype especially in loci 26 and 39 might exist. Furthermore, some patients with cavity lesions on chest films were associated with a cluster of Beijing family MTB strains, which can be defined by cluster analysis of 12-MIRU-VNTR genotype. However, the results of 12-loci-MIRU-VNTR genotyping in a longitudinal study should be interpreted with caution due to its short term instability. Further investigations of different molecular methodologies are necessary.