Biology subjects

Kateete, D. P.

Publications and source records attributed to Kateete, D. P..

6 recordsLinked to original sources

bioRxiv2026

Pulmonary Tuberculosis Is Associated with Body Site-Specific Alterations in the Respiratory and Gut Microbiome in Uganda

Abstract Background: Tuberculosis is a major infectious disease whose effects may extend beyond the lungs to influence microbial communities at other body sites. Although studies have reported alterations in the respiratory and gut microbiomes of people with TB, evidence from sub-Saharan Africa remains limited, and the extent to which these alterations differ between body sites is not fully understood. This study characterized sputum and stool microbiomes among Ugandan adults with pulmonary TB and those without TB. Methods: We conducted a cross-sectional study involving 200 participants, comprising 150 adults with pulmonary TB and 50 contacts, at Mulago National Referral Hospital in Kampala, Uganda. Sputum and stool samples were profiled using 16S rRNA gene sequencing. Following quality control and contaminant removal, within-sample diversity was assessed using multiple alpha diversity indices. Beta diversity was evaluated using distance-based methods, with group differences assessed by permutational multivariate analysis of variance (PERMANOVA) and homogeneity of dispersion tests. Differentially abundant taxa were identified using ANCOM-BC2. Results: After quality control, 135 sputum and 151 stool samples were retained for downstream analysis. In sputum, microbial richness estimators Chao1 and ACE were lower among TB cases than controls, whereas differences in overall community composition were not statistically significant after correction for multiple testing. In stool, several richness and diversity measures differed between groups, and beta-diversity analyses detected differences in community composition. However, TB cases exhibited greater within-group dispersion, and the sequencing platform contributed substantially to variation in stool microbial profiles. In multivariable analyses, the sequencing platform was the only factor independently associated with stool community composition after correction for multiple testing. Differential-abundance analyses identified body site-specific taxonomic associations with TB, including differences involving Streptococcus, Parvimonas, and Actinobacillus in sputum, and Dorea, Lachnoclostridium, and Turicibacter in stool. Conclusion: Pulmonary TB was associated with differences in microbial richness and the abundance of specific taxa in both sputum and stool, but evidence for overall community composition differences varied by body site and was influenced by dispersion and sequencing platform. These findings highlight the importance of examining both respiratory and gut microbial communities in TB research. Longitudinal studies using standardized sequencing methods are needed to clarify how these patterns change during treatment and whether they have diagnostic or clinical relevance.

genomics↗

bioRxiv2026

Comparative analyses of Gram-negative bacteria isolated from cancer patients with bacteraemia at the Uganda Cancer Institute

Antimicrobial resistance (AMR) exacerbates bacteraemia in cancer patients, particularly in low-resource settings. At the Uganda Cancer Institute, high rates of Enterobacterales producing extended-spectrum {beta}-lactamases (ESBLs) have been reported, with DNA-based detection of bla genes limited to PCR. This study aimed to determine whether bacterial genomic DNA shipped at ambient temperature from Uganda to the UK retained sufficient quality for whole-genome sequencing (WGS), to allow in-depth genomic analyses of isolates. Genomic DNA was extracted from Gram-negative bloodstream isolates (n=77) in Uganda and shipped to the UK at ambient temperature. rpoB gene (77/77, 100%) and WGS data (72/77, 93.5%) were generated for isolates, with 66/72 (91.7%) genomes of high-quality (Escherichia coli n=34; Klebsiella spp. n=32). Bioinformatic analyses included species identification, sequence typing, SNP analysis, AMR and virulence gene profiling, and comparison with publicly available genomes of Ugandan isolates. Phenotypic-genotypic concordance was generally high: 7/77 (9.1%) isolates were misidentified by phenotypic testing, and two showed unexplained carbapenem resistance. E. coli isolates showed diverse sequence types, with high prevalence of blaCTX-M (91.2%) and blaOXA-1 (47.1%); carbapenemase genes were rare. Klebsiella isolates lacked hypermucoidy loci and displayed diverse capsule types, with a high prevalence of ESBLs. Genomic clustering suggested limited within-hospital transmission of strains. Genomic data can provide important insights into the dissemination of bacterial subclades of global concern. The widespread AMR genotypes reported here highlight the need for improved diagnostics and updated treatment guidelines for bacteraemia in Ugandan cancer patients. IMPACT STATEMENTBloodstream infections are a major threat to cancer patients, particularly in low-resource settings where access to advanced diagnostics is limited and infection prevention may be challenging. This study shows that it is feasible to transport bacterial DNA at room temperature from Uganda to the UK for high-quality whole-genome sequencing, helping to overcome a logistical barrier to genomic surveillance. By applying genomic analysis to bacteria that had caused bloodstream infections at the Uganda Cancer Institute, we found that traditional laboratory methods can misidentify some bacteria, and that genomic analyses can provide more accurate and detailed insights into the bacteria causing these serious infections. Our work also highlights gaps in current treatment guidelines and demonstrates how genomic data could help inform updates to these, facilitating more effective antibiotic use in situations where urgent treatment is needed and there is no time to wait for laboratory test results. While there was limited evidence of direct transmission of bacteria between patients in our dataset, the genetic diversity and resistance patterns we observed are concerning and emphasise the need for ongoing monitoring and more extensive future studies.

microbiology↗

bioRxiv2025

Patterns of compensatory mutations in rpoA/B/C genes of multidrug resistant M. tuberculosis in Uganda

Mutations in rpoB, a gene that encodes the bacterial RNA polymerase (RNAP) beta-subunit, can cause high-level resistance to rifampicin. Approximately 95% of rifampicin-resistant Mycobacterium tuberculosis clinical isolates possess mutations in an 81-base pair rpoB region referred to as the rifampicin-resistance determining region (rpoB/RRDR). Also, rifampicin-resistant M. tuberculosis clinical isolates carry multiple mutations in RNAP genes (i.e., rpoA, rpoB, rpoC, rpoD), particularly rpoA and rpoC, which encode the alpha-(2) and beta'-({beta}') subunits, respectively. Such secondary mutations offset the fitness cost associated with rifampicin-resistance mutations in M. tuberculosis, resulting in resistant strains that are as fit as the wildtype drug-susceptible strains. To analyse the patterns of compensatory mutations in RNAP encoding genes of rifampicin-resistant M. tuberculosis clinical isolates in Uganda, whole genome sequencing and Sanger DNA sequencing were performed on 52 M. tuberculosis clinical isolates - 20 drug-susceptible and 32 multidrug resistant (MDR). A total of 24 (75%) MDR-TB isolates had high-level rifampicin-resistance conferring mutations in rpoB/RRDR i.e., Ser531Leu (31%); His526Asp (6%); His526Leu (3%); His526Tyr (3%); His526Arg (3%); His526Gly (3%); Asp516Tyr (13%); Asp516Val (6%); Glu513Lys (3%); Leu511Pro (3%); Leu492Leu (3%); Gln490Arg (3%). Further, two putative compensatory mutations (Gln490Arg & Lys1025Glu) outside the RRDR and not resistance conferring were found in rpoB. Altogether, 16 (50%) MDR-TB isolates with rpoB/RRDR resistance conferring mutations had non-synonymous mutations in rpoC of the following patterns Leu39Phe (3%); Tyr61His (3%); Asp271Gly (3%); Ser377Ala (3%); Pro481Thr (3%); Val483Ala (6%); Leu516Pro (3%); Ala521Asp (3%); Gly594Glu (13%); Asn698Ser (3%); Leu823Pro (3%). In conclusion, putative compensatory mutations are prevalent in rifampicin-resistant M. tuberculosis clinical isolates in Uganda, with rpoC/Gly594Glu and rpoC/Val483Ala as the most frequent. Further studies will determine their association with strain genetic background, fitness and transmission in an endemic setting with a high burden of HIV-TB coinfection.

microbiology↗

bioRxiv2024

Gut microbial profiling of COVID-19 patients in Uganda

BackgroundWhile COVID-19 spread globally, the role of the gut microbiota in patient outcomes has remained an area of exploration especially in resource limited settings. This study aimed to comprehensively profile the gut microbiome among Ugandan COVID-19 patients and infer potential implications. MethodsNasopharyngeal swabs, stool, clinical and demographic data were collected from COVID-19 confirmed cases at the COVID-19 isolation and treatment centers in Kampala and Entebbe, Uganda, during the first and second waves of the pandemic in Uganda (i.e., 2020 and 2021, respectively). SARS-CoV-2 presence in the swab samples was confirmed by quantitative real-time RT-PCR assays. 16S rRNA metagenomic next-generation sequencing was performed on the DNA extracted from the stool samples, followed by bioinformatics analysis. Machine learning was used to determine microbes that were associated with disease severity. ResultsWe observed varied gut microbial composition between COVID-19 patients and healthy controls. Potentially pathogenic bacteria such as Klebsiella oxytoca, Salmonella enterica and Serratia marcescens had an increased presence in COVID-19 disease states, especially severe cases. Enrichment of opportunistic pathogens, such as Enterococcus species, and depletion of beneficial microbes, like Alphaproteobacteria, was observed between mild and severe cases. Machine learning identified age and microbes such as Ruminococcaceae, Bacilli, Enterobacteriales, porphyromonadaceae, and Prevotella copri as predictive of severity. ConclusionThese findings suggest that the microbiome plays a role in the dynamics of SARS-CoV-2 infection in African patients. The shift in abundance of specific microbes can moderately predict severity of COVID-19 in this population. Their direct or indirect roles in determining severity should be investigated further for potential therapeutic interventions.

bioinformatics↗

bioRxiv2021

Phylogenomic analysis of Uganda influenza type-A viruses to assess their relatedness to the vaccine strains and other Africa viruses: a molecular epidemiology study.

BackgroundGenetic characterisation of circulating influenza viruses is essential for vaccine selection and mitigation of viral transmission. The current scantiness of viral genomic data and underutilisation of advanced molecular analysis methods on influenza viruses circulating in Africa has limited their extensive study and representation in the global influenza ecology. We aimed to sequence influenza type-A viruses (IAVs) that previously circulated in Uganda and characterised their genetic relatedness to the vaccine viruses and publicly available Africa IAVs. MethodsThis was an observational study nested to the Uganda national influenza surveillance programme. We used Next-generation sequencing to locally generate genomes from 116 A(H1N1)pdm09 and 118 A(H3N2) viruses collected between 2010 and 2018 from 7 districts across Uganda. A total of 206 hemagglutinin (HA), 207 neuraminidase (NA), and 213 matrix protein (MP) sequences were genetically compared to the WHO-recommended vaccines and other viruses isolated from Africa since 1994. Viral temporal and spatial divergence and circulating genetic clades were characterised using phylogenetic methods. FindingsWe successfully generated gene sequences for 91{middle dot}9% (215/234) viruses. Uganda A(H1N1)pdm09 and A(H3N2) virus HA, NA, and MP proteins had 96{middle dot}36-99{middle dot}09%, 96{middle dot}49-99{middle dot}39%, and 97{middle dot}48-99{middle dot}95% amino acid similarity, respectively, to vaccines recommended from 2010 through 2020. The local viruses incorporated amino acid substitutions (AAS) in their antigenic, receptor binding, and glycosylation sites each year causing them to antigenically drift away from vaccines. For seasons when vaccine formulations differed, Uganda IAV antigenic sites had 1-2 extra AAS relative to the Southern than Northern hemisphere vaccine viruses. All Uganda IAVs carried the adamantine-resistance marker S31N but not the neuraminidase inhibitor (NAI) resistance markers H274Y and H275Y. However, some A(H1N1)pdm09 viruses had permissive substitutions V234I, N369K, and V241I typical of NAI-resistant viruses. The 2017-2018 A(H1N1)pdm09 viruses belonged to global genetic clade 6B.1, while the A(H3N2) viruses isolated in 2017 belonged to clades 3C.2a and 3C.3a. Uganda IAVs obtained before 2016 clustered distinctly from other Africa viruses while later viruses mixed with other Africa, especially Kenya and Congo, and global viruses. Several unique viral lineages (bootstrap >90) persisted in Uganda and other countries for 1-3 years. InterpretationThe study reveals Uganda as part of the global influenza ecology with continuous importation, antigenic drift, and extensive local transmission of IAVs, presenting a potential risk of future outbreaks. For a country with limited health resources and where social distancing is not sustainable, viral prevention by vaccination should be prioritized. The notable viral diversity in Africa is a warning to countries to broaden and incorporate genome analysis in routine surveillance to monitor circulating and detect new viruses. This knowledge can inform virus selection for vaccine production and assist in developing cost-effective virus control strategies. FundingThis work was supported by the Makerere University-Uganda Virus Research Institute Centre of Excellence for Infection and Immunity Research and Training (MUII). MUII is supported through the Developing Excellence in Leadership, Training and Science (DELTAS) Africa Initiative (Grant no. 107743). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS), Alliance for Accelerating Excellence in Science in Africa (AESA), and supported by the New Partnership for Africas Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (Grant no. 107743) and the UK Government. The work was also funded in part by a Wellcome Trust grant (102975).

evolutionary biology↗

bioRxiv2020

Antibiotic resistance profiles and population structure of disease-associated Staphylococcus aureus infecting patients in Fort Portal Regional Referral Hospital, Western Uganda

Tackling antimicrobial resistance (AMR) is particularly challenging in low-resource settings such as Fort Portal Regional Referral Hospital (FPRRH) in Western Uganda. Specific knowledge of local AMR epidemiology is required to inform evidence-based improvement of antibiotic stewardship measures in the hospital. To address this, we combined existing antimicrobial susceptibility testing (AST) from FPRRH, with whole genome sequencing (WGS) of 41 Staphylococcus aureus isolates (2017-2019). AST revealed 73% (30/41) of isolates were resistant to one or more antibiotics and 29% (12/41) were multi-drug resistant (MDR). Resistance phenotypes were largely explained by the presence of antibiotic resistance genes in WGS data. Five isolates were methicillin-resistant S. aureus (MRSA) and MDR. Although all isolates were susceptible to clindamycin, a 24% carriage of erm genes suggests potential for rapid development of resistance. We inferred a population structure for the S. aureus isolates by comparing their core genomes. Twenty isolates formed a tight cluster corresponding to multilocus sequence typing clonal complex (CC) 152, a CC found to be particularly prevalent in northern Africa. The frequency of genes associated with methicillin, chloramphenicol and ciprofloxacin resistance were significantly lower among CC152 strains than non-CC152 strains; thus, in keeping with previous work, we find that CC152 is almost exclusively methicillin-sensitive S. aureus (MSSA). Also, in agreement with other studies, we observed that the occurrence of Panton-Valentine leukocidin toxin-encoding genes was significantly higher among CC152 strains than non-CC152 strains. However, we also observed that the coagulase gene was over-represented in this CC, further defining the virulence strategy of this important pathogen. By generating detailed information about the epidemiology of circulating S. aureus and their antibiotic susceptibility, our study has provided, for the first time, data on which evidence-based infection and AMR interventions at FPRRH can be based.

microbiology↗