Molecular clues of a microepidemy among homeless tuberculosis patients in Budapest due to a new and local Mycobacterium tuberculosis clade

Ködmön, Csaba; Niemann, Stefan; Gutiérrez, M. Cristina; Sola, Christophe; Rastogi, Nalin; Lukács, Judit; Somoskövi, Ákos

doi:10.1016/j.meegid.2007.06.003

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…By showing that historical strains can be accurately mapped to contemporary lineages, we have ruled out, for early modern Europe, the kind of scenario recently proposed for the Americas 3 , that is, wholesale replacement of one major lineage by another (with a different host range and presumed pathogen biology) and have confirmed the genotypic continuity of an infection that has ravaged the heart of Europe since prehistoric times 31 . With TB resurgent in many parts of the world, including Hungary 32 , the struggle to control this ancient infection is far from over. Here, we have shown that metagenomic approaches can document past infections.…”

Section: Discussionmentioning

confidence: 99%

Eighteenth-century genomes show that mixed infections were common at time of peak tuberculosis in Europe

et al. 2015

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Tuberculosis (TB) was once a major killer in Europe, but it is unclear how the strains and patterns of infection at ‘peak TB' relate to what we see today. Here we describe 14 genome sequences of M. tuberculosis, representing 12 distinct genotypes, obtained from human remains from eighteenth-century Hungary using metagenomics. All our historic genotypes belong to M. tuberculosis Lineage 4. Bayesian phylogenetic dating, based on samples with well-documented dates, places the most recent common ancestor of this lineage in the late Roman period. We find that most bodies yielded more than one M. tuberculosis genotype and we document an intimate epidemiological link between infections in two long-dead individuals. Our results suggest that metagenomic approaches usefully inform detection and characterization of historical and contemporary infections.

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Section: Discussionmentioning

confidence: 99%

Eighteenth-century genomes show that mixed infections were common at time of peak tuberculosis in Europe

et al. 2015

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“…Nosocomial transmission of TB in urban hospitals [67,68], and effective IC measures in these healthcare settings [69], have been described in the EU. Transmission in hostels and shelters attended by risk groups, and prisons in big cities in the EU, have been suggested by conventional epidemiological studies [70] and strong evidence is supplied by molecular epidemiological studies using DNA fingerprint cluster analysis [13,16,19,[71][72][73][74][75]. Congregate settings in big cities in the EU can implement hygienic measures (proper room ventilation and illumination, no overcrowding, cough hygiene) and organise TB awareness-raising activities.…”

Section: Infection Control In Community Settings and Big Citiesmentioning

confidence: 99%

Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement

et al. 2014

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In low-incidence countries in the European Union (EU), tuberculosis (TB) is concentrated in big cities, especially among certain urban high-risk groups including immigrants from TB high-incidence countries, homeless people, and those with a history of drug and alcohol misuse. Elimination of TB in European big cities requires control measures focused on multiple layers of the urban population. The particular complexities of major EU metropolises, for example high population density and social structure, create specific opportunities for transmission, but also enable targeted TB control interventions, not efficient in the general population, to be effective or cost effective. Lessons can be learnt from across the EU and this consensus statement on TB control in big cities and urban risk groups was prepared by a working group representing various EU big cities, brought together on the initiative of the European Centre for Disease Prevention and Control. The consensus statement describes general and specific social, educational, operational, organisational, legal and monitoring TB control interventions in EU big cities, as well as providing recommendations for big city TB control, based upon a conceptual TB transmission and control model.

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“…Although this strategy is of little use for universal molecular epidemiology programs, it might be able to solve many of the practical problems often faced by clinical mycobacteriology laboratories, namely, resolution of laboratory cross-contamination alerts (7)(8)(9), discrimination between reactivation and exogenous reinfection (10), analysis of suspected microepidemics (11,12), and tracking of the spread of specific high-risk strains (9,(13)(14)(15).…”

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confidence: 99%

Qualitative Analysis To Ascertain Genotypic Identity of or Differences between Mycobacterium tuberculosis Isolates in Laboratories with Limited Resources

Sislema-Egas¹,

Ruiz‐Serrano²,

Bouza³

et al. 2013

J Clin Microbiol

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dMycobacterium tuberculosis is currently genotyped using mycobacterial interspersed repetitive-unit-variable-number tandemrepeat (MIRU-VNTR) typing, although the high cost of this technique restricts its implementation in resource-limited settings. We designed a MIRU-VNTR format, MLP3 (MIRU-VNTR length polymorphism triplex), that is based on the qualitative comparison of 5 nonfluorescent 3-band fingerprints in conventional electrophoresis and minimizes costs and technical demands. MLP3 successfully resolved cross-contamination alerts, discriminated reinfections from reactivations, clarified suspected microepidemics, and tracked transmission events of high epidemiological interest. In recent years, the preferred genotyping strategy for fingerprinting Mycobacterium tuberculosis isolates has switched from IS6110 restriction fragment length polymorphism analysis to a PCR-based method, mycobacterial interspersed repetitive-unitvariable-number tandem-repeat (MIRU-VNTR) typing, which is faster, requires a lower bacterial load, facilitates data interchange with other laboratories, and offers equivalent discriminatory power (1-3). The 2 available formats of MIRU-VNTR, based on the use of 15 or 24 loci (MIRU-15 and MIRU-24, respectively), are the most-suitable approaches for epidemiological purposes, although the 15-locus format offers sufficient discriminatory power in most settings (4, 5). A high-throughput adaptation of MIRU-VNTR has also been developed. It requires fluorescent primers, multiplexing, and allele calling based on sizing of the amplified fragments by capillary electrophoresis (6). None of these alternatives is suitable for low-resource laboratories: the standard approach requires a high number of PCRs and access to image capture systems and specific software before allelic values can be assigned, and while the high-throughput approach reduces the number of PCRs, it increases equipment and software costs (3).Our objective in this study was to evaluate an easier and lessexpensive format of MIRU-VNTR analysis aimed not at performing the standard scheme (i.e., sizing the MIRU PCR products to assign a strain-specific numerical code on which comparisons are based) but at performing a qualitative analysis to ascertain identities or differences between isolates. Although this strategy is of little use for universal molecular epidemiology programs, it might be able to solve many of the practical problems often faced by clinical mycobacteriology laboratories, namely, resolution of laboratory cross-contamination alerts (7-9), discrimination between reactivation and exogenous reinfection (10), analysis of suspected microepidemics (11,12), and tracking of the spread of specific high-risk strains (9, 13-15).We designed and evaluated a new approach, which we call MLP3 (MIRU-VNTR length polymorphism triplex). MLP3 is based on nonfluorescent triplex PCRs and separation of the amplified products using conventional agarose electrophoresis. This approach considers the electrophoretic mobility of the 3-band pattern itself as ...

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Molecular clues of a microepidemy among homeless tuberculosis patients in Budapest due to a new and local Mycobacterium tuberculosis clade

Cited by 3 publications

References 18 publications

Eighteenth-century genomes show that mixed infections were common at time of peak tuberculosis in Europe

Eighteenth-century genomes show that mixed infections were common at time of peak tuberculosis in Europe

Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement

Qualitative Analysis To Ascertain Genotypic Identity of or Differences between Mycobacterium tuberculosis Isolates in Laboratories with Limited Resources

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