Molecular Epidemiology of
            <i>Mycobacterium tuberculosis</i>
            in Western Sweden

Brudey, Karine; Gordon, Max; Moström, Peter; Svensson, Lars; Jönsson, Bodil; Sola, Christophe; Ridell, Malin; Rastogi, Nalin

doi:10.1128/jcm.42.7.3046-3051.2004

Cited by 41 publications

(34 citation statements)

References 33 publications

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“…This could reflect the likelihood of infection having occurred in the country of origin prior to entry to Italy or within particular ethnic communities in the host country. This is in agreement with the widely accepted hypothesis that in low-prevalence countries, foreign-born people are infected in their country of origin and then develop disease shortly after immigration (5,7,8,21). Similar observations of limited transmission from foreign-born patients to United States-born individuals have been reported from molecular cluster analyses in San Francisco (6,17) and, more recently, by Hirsh et al (16) using deletion analysis.…”

Section: Discussionsupporting

confidence: 78%

Three-Year Longitudinal Study of Genotypes of Mycobacterium tuberculosis Isolates in Tuscany, Italy

et al. 2007

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The genetic diversity of 829 strains of Mycobacterium tuberculosis isolated during a 3-year period in Tuscany, Italy, a country with a low prevalence of tuberculosis, from 480 Italian-born and 349 foreign-born patients was determined by spoligotyping. The predominant spoligotype families were T (30.2% of isolates), Haarlem (19.9%), and the Latino-American and Mediterranean family (LAM) (11.2%); the remaining isolates were distributed among the Beijing (6.5%), S (4.2%), East Africa-India (EAI) (3.0%), Bovis (2.3%), Central Asia (CAS) (2.1%), Africanum (1.3%), and X (1.2%) families or were undefined (2.7%) or orphan (14.1%) isolates. Isolates of the families T, Haarlem, Bovis, and X were distributed among Italian-and foreign-born patients almost proportionally to the patients' numbers. Isolates of the LAM family were prevalent in foreign-born people (13.5%, versus 9.6% in Italian-born patients). Isolates of the S family were found almost exclusively in Italian-born patients, while strains of families EAI and CAS were isolated almost exclusively from foreign-born patients; Africanum isolates were all from African-born patients. The isolates of the Beijing family showed a trend to a steady increase during the survey. The prevalence of Beijing strains was 11.7% among foreign-born people and 2.7% among Italian-born patients. The Beijing strains were typed by the standardized IS6110 restriction fragment length polymorphism assay, which yielded a total of 38 distinct IS6110 patterns; 21 isolates (39.6%) occurred in six distinct clusters; of these, three contained two isolates and the other three contained four, five and six isolates, thus demonstrating that Beijing strains caused several tuberculosis outbreaks in the region. These findings indicate that transmission of Beijing strains between immigrants and the autochthonous population has occurred frequently and suggests an ongoing active transmission of the Beijing genotype in the region.Tuberculosis (TB) is the world's second-most-common cause of death from an infectious disease, after human immunodeficiency virus/acquired immune deficiency syndrome, causing nearly 2 million deaths, 50 to 100 million infections, and 8 to 9 million new cases every year (13). As the global burden of TB falls principally on developing countries, where 95% of cases and 98% of deaths due to the disease occur (31), it is not surprising that much of TB in the Western world occurs in foreign-born immigrants from countries with a high prevalence of TB. Accurate estimates of the impact of immigration in low-prevalence countries and of other interdependent host-related factors, such as the distribution of human immunodeficiency virus/acquired immune deficiency syndrome in the population and the aging of the indigenous population (3,25), are essential to design appropriate strategies for TB control.The demographic characteristics of the population of Italy provide an excellent opportunity to investigate the impact of immigration on TB epidemiology in a low-prevalence Western European country. It...

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Section: Discussionsupporting

confidence: 78%

Three-Year Longitudinal Study of Genotypes of Mycobacterium tuberculosis Isolates in Tuscany, Italy

et al. 2007

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“…This remarkable difference was also reflected by the rate of recent transmission that was as high as 49.3% in French Guiana, compared to 16.9% and 27.2% in Martinique and Guadeloupe, respectively. Thus, the rate of recent transmis- sion in FWI is relatively low, with values for Martinique being close to those reported in low-incidence areas like Sweden (14.1% [4]), and London, England (14.4% [17]), and those for Guadeloupe being similar to Denmark (24% [34]) and Paris, France (25% 15). On the contrary, the rate of recent transmission of TB in French Guiana with a value of around 50% is close to data reported from high-incidence areas like Equatorial Guinea (28), Zimbabwe (10), Cape Town, South Africa (31), and Antananarivo, Madagascar (19).…”

Section: Discussionmentioning

confidence: 69%

“…As explained in a previous study (4), all the isolates with the exception of true orphans in the database were attributed a clade designation based on minor and major visual rules for spoligotyping-based classification (12,22). As summarized in Tables 2 and 3, this permitted us to designate 11 clades: Africanum; Beijing; Bovis; Central Asia [CAS]; East-African Indian [EAI]; Haarlem, Latin-American, and Mediterranean [LAM]; Manu; S; X; and an ill-defined T clade.…”

Section: Resultsmentioning

confidence: 88%

Long-Term Population-Based Genotyping Study of Mycobacterium tuberculosis Complex Isolates in the French Departments of the Americas

et al. 2006

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The three French overseas departments of the Americas are characterized both by insular (Guadeloupe and Martinique) and continental (French Guiana) settings with a tuberculosis case detection rate that varies from less than 10 per 100,000 per year in insular areas to an estimated incidence of more than 55 per 100,000 in French Guiana. Under a long-term genotyping program, more than three-fourths of all the Mycobacterium tuberculosis isolates (n ‫؍‬ 744) received from the three settings were fingerprinted over a 10-year period (1994 to 2003) by spoligotyping and variable number of tandem DNA repeats (VNTRs) in order to understand the current trends in their detection rates, drug resistance, and groups and subpopulations at risk of contracting the disease and to pinpoint the circulating phylogeographical clades of the bacilli. The major difference in the study populations was the nationality of the patients, with a high percentage of immigrants from highincidence neighboring countries in French Guiana and a low but increasing percentage in the French Caribbean. The rate of recent transmission was calculated to be 49.3% in French Guiana, compared to 27.2% and 16.9% in Guadeloupe and Martinique, respectively. At the phylogeographic level, 77.9% of the isolates studied belonged to four major clades (Haarlem, Latin-American and Mediterranean, T, and X) which are already reported from neighboring Caribbean islands in an international database and may underline potential interregional transmission events.

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“…Nevertheless, there are conflicting results in the literature on the relative transmissibility of drug-resistant and drug-sensitive M. tuberculosis strains. While some studies showed that drugresistant isolates were less likely to be associated with clustering (46,48), others identified drug resistance as a strong predictor of being in a cluster (1,10). In spite of a high degree of genetic diversity, an important part (41.3%), of the analyzed MDR strains belonged to one of the four clusters SIT53, SIT891, SIT1, and SIT1557.…”

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confidence: 99%

Spoligotype-Based Comparative Population Structure Analysis of Multidrug-Resistant and Isoniazid-Monoresistant Mycobacterium tuberculosis Complex Clinical Isolates in Poland

Jagielski¹,

Augustynowicz–Kopeć²,

Zozio

et al. 2010

J Clin Microbiol

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The spoligotyping-based population structure of multidrug-resistant (MDR) Mycobacterium tuberculosis strains isolated in Poland (n ‫؍‬ 46), representing all culture-positive MDR tuberculosis (MDR-TB) cases, was compared to that of isoniazid (INH)-monoresistant strains (n ‫؍‬ 71) isolated in 2004. The latter data set from a previous study (E. Augustynowicz-Kopeć, T. Jagielski, and Z. Zwolska, J. Clin. Microbiol. 2008, 46:4041-4044) represented 87% of all INH-monoresistant strains. The clustering rates and genotypic-diversity indexes for the 2 subpopulations were not significantly different (P ‫؍‬ 0.05). The results were entered in the SITVIT2 database to assign specific shared type designations, corresponding genotypic lineages, and geographical distributions and compared to available data from neighboring countries (Germany, n ‫؍‬ 704; Czech Republic, n ‫؍‬ 530; Sweden, n ‫؍‬ 379; Kaliningrad, Russia, n ‫؍‬ 90) and strains from previous studies in Poland (n ‫؍‬ 317). MDR strains resulted in 27 patterns (20 unique strains within the study and 7 clusters containing 2 to 6 isolates per cluster with a clustering rate of 56.5%) and belonged to the following genotypic lineages: ill-defined T family (28.3%), Haarlem (17.4%), Latin American and Mediterranean (LAM) (13%), Beijing (8.7%), S family (4.35%), and the X clade (2.17%). Comparison of the genetic structure of the MDR strains with that of INH-monoresistant strains showed that a total of 9 patterns were shared by both groups; these represented 1/3 of the MDR strains and 2/3 of the INH-monoresistant strains. Interestingly, 76.1% of the MDR isolates and 71.8% of the INH-resistant isolates yielded spoligotypes that were previously reported from Poland. The observation that nearly half of the spoligotypes identified among both MDR (48.1%) and INH-monoresistant (43.3%) M. tuberculosis isolates were present in Poland's neighboring countries suggested that a significant proportion of MDR and INH-resistant TB cases in Poland were caused by strains actively circulating in Poland or its neighbors. Our results corroborate the leading role of the T and Haarlem genotypes in the epidemiology of drug-resistant TB in Poland. Nevertheless, the LAM and Beijing family strains that infected, correspondingly, 13% and 9% of patients with MDR-TB were absent among the strains from patients with INHmonoresistant TB, suggesting that a proportion of MDR-TB cases in Poland are due to ongoing transmission of MDR clones exhibiting specific genotypes. Study of the population genetic relationships between MDR and INH-monoresistant strains by drawing minimum spanning trees showed that ill-defined T1 sublineage strains (1/3 of all INH-monoresistant strains), represented by its prototype, SIT53, constituted the central node of the tree, followed by strains belonging to the well-defined H3, H1, and S subgroups. However, the MDR group, in addition, contained LAM (n ‫؍‬ 6) and Beijing (n ‫؍‬ 4) lineage isolates. With the exception of the 4 Beijing lineage strains in the latter group and a single orpha...

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Molecular Epidemiology of Mycobacterium tuberculosis in Western Sweden

Cited by 41 publications

References 33 publications

Three-Year Longitudinal Study of Genotypes of Mycobacterium tuberculosis Isolates in Tuscany, Italy

Three-Year Longitudinal Study of Genotypes of Mycobacterium tuberculosis Isolates in Tuscany, Italy

Long-Term Population-Based Genotyping Study of Mycobacterium tuberculosis Complex Isolates in the French Departments of the Americas

Spoligotype-Based Comparative Population Structure Analysis of Multidrug-Resistant and Isoniazid-Monoresistant Mycobacterium tuberculosis Complex Clinical Isolates in Poland

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