Application of whole-genome sequencing for distinguishing relapse from reinfection in tuberculosis patients from Lithuania

•Reinfection accounted for 40% of recurrent tuberculosis (TB) cases.•Half of the TB treatment failures were found to be reinfections.•Only 55% of patients were correctly differentiated as relapse or treatment failure.•Extensively drug-resistant TB emerged undetected due to limited diagnostics. Tuber...

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Vydané v:International journal of infectious diseases Ročník 162; s. 108203
Hlavní autori: Vasiliauskaitė, Laima, Zinola, Alma, Marco, Federico Di, Davidavičienė, Valerija Edita, Nakčerienė, Birutė, Vaitulionytė, Agnė, Cirillo, Daniela Maria, Kačergius, Tomas
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Canada Elsevier Ltd 01.01.2026
Elsevier
Predmet:
Infectious Disease
Pulmonary/Respiratory
Recurrence
Reinfection
Relapse
Tuberculosis
Whole-genome sequencing
Recurrence
Relapse
Tuberculosis
Reinfection
Whole-genome sequencing
recurrence
reinfection
relapse
whole-genome sequencing
ISSN:1201-9712, 1878-3511, 1878-3511
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Shrnutí:•Reinfection accounted for 40% of recurrent tuberculosis (TB) cases.•Half of the TB treatment failures were found to be reinfections.•Only 55% of patients were correctly differentiated as relapse or treatment failure.•Extensively drug-resistant TB emerged undetected due to limited diagnostics. Tuberculosis (TB) can reoccur even after successful treatment due to endogenous reactivation or exogenous reinfection. Understanding the aetiology of TB recurrence might prevent further transmission and development of resistance. Therefore, this study aimed to assess the rate of true TB relapses versus reinfection among patients with TB recurrence in Lithuania using whole-genome sequencing (WGS). This study included 62 Mycobacterium tuberculosis complex (MTBC) strains recovered from 29 pulmonary TB patients who had at least one reported TB recurrence or treatment failure episode between 2016 and 2023. To investigate potential sources of transmission in reinfected patients, 4 additional MTBC sequences were included in the analysis. The analysis of WGS results was performed using an in-house bioinformatic pipeline. A cut-off of 5 single nucleotide polymorphisms was used to differentiate between relapse and reinfection. Majority (60%) of all recurrent TB cases were caused by true relapse, while reinfections with a different strain accounted for 40%. Moreover, half of the treatment failures were also found to be reinfections. The risk of reinfection is underestimated in Lithuania, highlighting the need for rapid changes in diagnostics and infection control strategies to contain the transmission of extensively drug-resistant TB (XDR-TB) strains in Lithuania.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1201-9712
1878-3511
1878-3511
DOI:10.1016/j.ijid.2025.108203