Hyper transmission of Beijing lineage Mycobacterium tuberculosis: Systematic review and Meta-analysis

Malancha Karmakar, James M. Trauer, David B. Ascher, Justin T. Denholm

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9 Citations (Scopus)


OBJECTIVES: The globally distributed "Beijing" lineage of Mycobacterium tuberculosis has been associated with outbreaks worldwide. Laboratory based studies have suggested that Beijing lineage may have increased fitness; however, it has not been established whether these differences are of epidemiological significance with regards to transmission. Therefore, we undertook a systematic review of epidemiological studies of tuberculosis clustering to compare the transmission dynamics of Beijing lineages versus the non-Beijing lineages. METHODS: We systematically searched Embase and MEDLINE before 31st December 2018, for studies which provided information on the transmission dynamics of the different M. tuberculosis lineages. We included articles that conducted population-based cross-sectional or longitudinal molecular epidemiological studies reporting information about extent of transmission of different lineages. The protocol for this systematic review was prospectively registered with PROSPERO (CDR42018088579). RESULTS: Of 2855 records identified by the search, 46 were included in the review, containing 42,700 patients from 27 countries. Beijing lineage was the most prevalent and highly clustered strain in 72.4% of the studies and had a higher likelihood of transmission than non-Beijing lineages (OR 181 [95% 128-257], I2 = 940%, tau2 = 059, p < 001). CONCLUSIONS: Despite considerable heterogeneity across epidemiological contexts, Beijing lineage appears to be more transmissible than other lineages.
Original languageEnglish
Pages (from-to)572-581
Number of pages10
JournalJournal of Infection
Issue number6
Publication statusPublished - Dec 2019

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