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J Med Microbiol 57 (2008), 864-872; DOI: 10.1099/jmm.0.47483-0
© 2008 Society for General Microbiology
ISSN 1473-5644

Genetic profiling of Mycobacterium tuberculosis in Tunisia: predominance and evidence for the establishment of a few genotypes

Amine Namouchi1, Anis Karboul1, Besma Mhenni1, Neila Khabouchi1, Raja Haltiti2, Ridha Ben Hassine3, Béchir Louzir4, Abdellatif Chabbou5 and Helmi Mardassi1

1 Unit of Typing and Genetics of Mycobacteria, Institut Pasteur de Tunis (Tunisia), 13 Place Pasteur, BP 74, Tunis, Tunisia

2 Hôpital Régional de Menzel-Bourguiba, Menzel-Bourguiba, Tunisia

3 Hôpital Régional de Zaghouan, Zaghouan, Tunisia

4 Hôpital la Rabta, Tunis, Tunisia

5 Hôpital Abderrahman Mami de Pneumo-Phtisiologie, Ariana, Tunisia

Correspondence
Helmi Mardassi
helmi.merdassi{at}pasteur.rns.tn

Received 29 June 2007
Accepted 31 January 2008

Typing analyses of 378 Mycobacterium tuberculosis isolates collected between the years 2001 and 2005 from three northern representative regions of Tunisia revealed a highly homogeneous population. Indeed, 84.9 % of all tuberculosis (TB) cases were attributed to the Haarlem, LAM or T families. Strikingly, within each family, more than 60 % of TB cases were due to a single genotype. ST50 (Haarlem3) and ST42 (LAM9) genotypes were exceptionally predominant, representing 46.3 % of all typed isolates. ST50 showed an increased tendency for clustering and was more predominant in the extreme north of the country. By contrast, the more widespread ST42, which was apparently prevalent 17 years ago, displayed weak cluster individualization and a low transmission rate, consistent with its stable association with the Tunisian population. It is believed that both mass BCG vaccination, strictly applied for four decades, and the high endogamy rate that characterizes the Tunisian population could have profoundly shaped the population structure of M. tuberculosis by concurrently favouring the selection and accommodation of particular genotypes.

Abbreviations: BCG, Bacille Calmette–Guérin; MDR, multidrug-resistant; MIRU-VNTR, mycobacterial interspersed repetitive units-variable number of tandem repeats; ST, shared type; TB, tuberculosis.




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