ORIGINAL RESEARCH article
Front. Public Health
Sec. Infectious Diseases: Epidemiology and Prevention
This article is part of the Research TopicLeveraging Real-Time Genomic Surveillance to Combat Infectious Diseases and Antimicrobial ResistanceView all 15 articles
Transmission characteristics of tuberculosis in the High-TB-Burden Region of Southwest China
Provisionally accepted
- Yunnan Center for Disease Control and Prevention, Kunming, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Whole genome sequencing (WGS) can provide valuable insights into the transmission patterns of Mycobacterium tuberculosis, which can inform effective intervention strategies for controlling tuberculosis (TB) in local areas. Methods: We conducted a retrospective study using strains isolated from L County between January 2019 and July 2020. Demographic data of patients were retrieved from National Tuberculosis Information Management System. A whole genome sequencing-based clustering analysis was performed to assess the transmission characteristics of pulmonary TB in L County. Univariate and multivariate logistic regression analyses were employed to identify potential risk factors associated with clustering. Results: A total of 143 strains from 136 confirmed TB cases were available for analysis, among them 74.26% of M. tuberculosis strains belonged to Lineage 2, while Lineage 4 comprised the reminder. Among the pulmonary TB cases, 38.97% (53/136) exhibited genomic-clustered strains (≤12 SNP threshold). Notably, 29 (62.26%) strains belonging to 15 clusters were isolated from the same township, while 10 (18.87%) strains belonging to 5 clusters originated from the same villages. The younger age group ( ≤44)exhibited a higher risk of clustering (aOR 19.21, 95% CI: 2.37-155.80, P=0.006). Additionally, 9 (27.27%) drug resistant (DR) strains were identified within cluster, and 4 serial DR strains of 2 patients showed the accumulation of acquired drug resistance. Conclusion: A significant proportion of tuberculosis cases in L County are attributed to recent transmission occurring within communities or neighborhoods across townships for both sensitive and drug-resistant TB . These findings suggest that an active case-finding strategy should be implemented in this area to identify patients at the early stages. Furthermore, active screening should not only target key populations such as close household contacts or elderly individuals but also extend to all residents aged fifteen years and older. Improving chemotherapy treatment quality and patient follow-up is essential in L County.
Keywords: Mycobacterium tuberculosis, whole genome sequencing, High burden setting, Cluster analysis, Transmission pattern
Received: 21 Jul 2025; Accepted: 28 Oct 2025.
Copyright: © 2025 Yang, Ru, Chen, Chen, Ni, Yan, Yang, Chen and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lin Xu, 123316859@qq.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.