P60
Integrating genomics and refined epidemiology to analyze tuberculosis transmission dynamics involving pediatric population
S Vallejo Godoy(1) M Martínez-Lirola(2) P Barroso García(3) F Escabias Machuca(4) M Herranz(5,6,7) J A Garrido-Cárdenas(8) A B Esteban García(8) P Muñoz(5,6,7,9) D García de Viedma(5,6,7) L Pérez-Lago(5,6)
1:USP Distrito Sanitario Poniente de Almería, Servicio Andaluz de Salud, Almería, España; 2:Servicio de Microbiología y Parasitología, Complejo Hospitalario Torrecárdenas, Almería, España; 3:Distrito Sanitario Amería, Servicio Andaluz de Salud, Almería, España; 4:Área Sanitaria Norte de Almería, Servicio Andaluz de Salud, Almería, España; 5:Laboratorio de Genómica Microbiana, Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, España; 6:Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; 7:CIBER Enfermedades Respiratorias (CIBERES), España; 8:Departamento de Biología y Geología, Universidad de Almería, España; 9:Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, España
Children with active tuberculosis are considered indicative of recent transmission and therefore, behave as sentinels to monitor transmission in the community. Our aim was to apply genomic epidemiology to analyze tuberculosis transmission dynamics in children (0-10 years) and adolescents (11-17 years) in a complex epidemiological setting, Almería (Spain), one of the main migration gateways into Europe from countries with a high TB incidence. Between 2003 and 2021, 87 cases of pediatric tuberculosis were diagnosed, 45 in children (31 migrants) and 42 in adolescents (26 migrants). 24-MIRU-VNTR genotyping was available for 82 cases, which distributed them in 28 orphan cases (75% migrants, mostly recently arrived adolescents) while 54 were involved in clusters (61% migrants, mostly children). Most of the MIRU-VNTR clusters involving pediatric cases (74%) were reanalyzed by WGS (total cases: 171), which allowed us to: i) confirm part of the family microepidemics previously suspected by the epidemiological research (62,5%); moreover, in 6 cases the family link initially assumed was ruled out, ii) identify transmission environments not previously suspected and iii) relabel as orphan cases that had been misassigned as clustered by MIRU-VNTR, most of them likely corresponding to migrants importing strains. The integration of genomics in the study TB-transmission involving pediatric cases was key to defining the true epidemiological relationships and to reorientate the epidemiological investigation towards new settings not previously considered.
*Presenting author
Funding: ISCIII (PI21/01823, PI19/00331, CPII20/00001), Junta de Andalucía (AP-0062-2021-C2-F2) and European Regional Development Funds (FEDER) from the European Commission, “A way of making Europe”.