Mycobacterium tuberculosis in Israel in 2021

This is a collection of all Mycobacterium tuberculosis genomes from new laboratory-confirmed TB patients reported in Israel in 2021. The State of Israel has a large number of immigrants from different countries. Most of the morbidity in tuberculosis is among patients who were not born in Israel. Of the 154 new laboratory-confirmed TB patients reported, 66.7% had intrapulmonary TB, while 16% had extra-pulmonary TB. Males accounted for 52% of the patients, with the prevalent age group being 21-40. Most patients were citizens of Israel (53.9%), while 37.7% had no citizenship. Among non-citizens, there was a predominance of males and patients aged 21-40. Only 11.7% of the newly diagnosed TB patients were born in Israel, with 38.3% born in Africa. The susceptibility profile showed a high resistance rate to streptomycin (18.2%) and to a lower extent to isoniazid (13.6%), pyrazinamide (8.4%), rifampicin (7.8%), and ethambutol (3.2%). Two XDR-TB and 10 MDR-TB strains were detected in 2021, with both XDR strains and five out of 10 MDR strains belonging to the Beijing lineage. Most of Beijing isolates are resistant to at least one tested drug. Genomic sequencing of 134 out of 156 strains and bioinformatics analysis using the MTBseq program and WHO mutation catalogue, shows a good match with only five discrepancies between phenotypic and genotypic susceptibility profiles. The most common lineage is Delhi-Cas (23%) followed by the Beijing lineage (17%). Most patients from the Delhi-Cas lineage were born in Africa, while patients with Beijing isolates were born in different countries. Minimum spanning tree analysis identify 15 clusters.