# Predominance of Uganda genotype of Mycobacterium tuberculosis isolated from Ugandan patients with tuberculous lymphadenitis

## TL;DR

This study finds that the Uganda genotype of tuberculosis is common in Ugandan patients with lymph node infections, but less so than in lung infections.

## Contribution

The study identifies the Uganda genotype as predominant in extrapulmonary TB cases in Uganda, with insights into its global evolution.

## Key findings

- The Uganda genotype is the dominant genotype in tuberculous lymphadenitis in Uganda.
- The spoligotype SIT420 is the most common among isolates, with others previously linked to pulmonary TB.
- Phylogenetic analysis shows ongoing evolution of the Uganda genotype centered in Uganda.

## Abstract

In Uganda, the emerging Uganda genotype of Mycobacterium tuberculosis is the most common cause of pulmonary tuberculosis (PTB), and accounts for up to 70 % of isolates. Extrapulmonary TB (EPTB) is less studied in Uganda.

Molecular characterization using deletion analysis and spoligotyping was performed on 121 M. tuberculosis isolates from lymph node fine needle biopsy aspirates of Ugandan patients
with tuberculous lymphadenitis. The evolutionary relationships and worldwide distribution of the spoligotypes were analyzed.

Mycobacterium tuberculosis was the only cause of EPTB in this study. The T2 sublineage was the most predominant lineage and the Uganda genotype was the dominant genotype. There were 54 spoligotype patterns among the 121 study isolates. The dominant spoligotypes were shared international types (SIT) SIT420, SIT53, SIT 135, SIT 128 and SIT590 in descending order. All but SIT420 were previously reported in pulmonary TB in this setting. The phylogenetic analysis showed a long descendant branch of spoligotypes belonging to the T2-Uganda sublineage containing specifically SITs 135, 128 and 420.

In most cases, the spoligotypes were similar to those causing PTB, but the Uganda genotype was found to be less common in EPTB than previously reported for PTB in Uganda. The phylogenetic analysis and the study of the worldwide distribution of clustered spoligotypes indicate an ongoing evolution of the Uganda genotype, with the country of Uganda at the center of this evolution.

The online version of this article (doi:10.1186/s13104-015-1362-y) contains supplementary material, which is available to authorized users.