Database comparison and geographical distribution of spoligotypes The obtained octal spoligotypes codes were entered into the SITVIT2 database. In this database, two or more patient isolates sharing identical spoligotype patterns are define as SIT (Spoligotype International Type) whilst single spoligopatterns are defined as “”orphan”" isolates. Major phylogenetic clades were assigned according to signatures provided in SpolDB4. The SpolDB4 defines 62 genetic lineages/sub-lineages [14] and includes specific signatures for various M. tuberculosis complex
members such as M. bovis, M. caprae, M. microti, M. canettii, M. pinipedii, and M. africanum, as well as including rules for defining the major lineages/sub-lineages MM-102 concentration for M. tuberculosis sensu stricto. At the time of the present study, SITVIT2
ARS-1620 concentration contained more than 3000 SITs with global genotyping information on around 74,000 M. tuberculosis clinical isolates from 160 countries of origin. The worldwide distribution of predominant spoligotypes found in this study (SITs representing 4 or more strains) was EX 527 concentration further investigated using the SITVIT2 database, and regions with ≥5% of a given SIT as compared to their total number in the SITVIT2 database, were recorded. The various macro-geographical regions and sub-regions were defined according to the specifications of the United Nations [16]. The same criteria were used to compare the distribution by country of predominant SITs (countries with ≥5% of a given SIT). The three-letters country codes were used as defined in the ISO 3166 standard [17]. Comparison of spoligotypes families and principal genetic groups The overall distribution of strains, according to the major M. tuberculosis spoligotyping-defined families, was compared to the principal genetic groups (PGG) based on KatG463-gyrA95 polymorphisms [18]. The comparison was inferred Non-specific serine/threonine protein kinase from the
reported linking of specific spoligotype patterns to PGG1, 2 or 3 [19–21]. Restriction fragment length polymorphism The standard RFLP protocol [6] was used to further characterize 43 strains found to belong to a single spoligotype cluster. Briefly, the genomic mycobacterial DNA was digested by the restriction enzyme Pvu II and separated by gel electrophoresis. Following southern blot, samples were hybridized with the probe IS6110 and detected by chemiluminescence (Amersham ECL direct™ nucleic acid labeling and detection system, GE Healthcare Limited, UK) using X-ray films (Amersham Hyperfilm™ ECL, GE Healthcare Limited, UK). The M. tuberculosis strain 14323 was used as an external marker for the comparison of patterns and the BioNumerics software was used to analyze the patterns obtained. A dendrogram was constructed to show the degree of similarity among the strains using the un-weighted pair group method of arithmetic average (UPGMA) and the Jaccard index (1% tolerance, 0.5% optimization).