Predictors of tuberculosis transmission in prisons: an analysis using conventional and molecular methods

March, Francesca; Coll, Pere; Guerrero, Rafael; Busquets, Esther; Caylà, Joan A.; Prats, Guillem

doi:10.1097/00002030-200003310-00008

Cited by 34 publications

(32 citation statements)

References 43 publications

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“…During the last 15 years, ME has been broadly used in the study of TB transmission, representing an important improvement in the detection and description of TB clusters, (6,20,21,22,30,34) as well as in studies of TB transmission at a population level (2,5,11,12,19). Since the beginning of its use, several studies have shown a proportion of cases with no correlation between the results of the two methods.…”

Section: Discussionmentioning

confidence: 99%

“…Among the control measures currently in use, the detection of new infections and secondary cases by conventional contact tracing (CCT) is fundamental (39). During the last 15 years, molecular epidemiology (ME) techniques have been demonstrated to be helpful in the study of TB transmission, and they have been applied to population studies (2,5,11,12,19,30), such as those of defined risk groups (22,34) and analyses of outbreaks (6,20,21).…”

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Factors Associated with Differences between Conventional Contact Tracing and Molecular Epidemiology in Study of Tuberculosis Transmission and Analysis in the City of Barcelona, Spain

et al. 2009

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The aim of this study was to analyze the factors associated with conventional contact tracing (CCT) and molecular epidemiology (ME) methods in assessing tuberculosis (TB) transmission, comparing the populations studied and the epidemiological links established by both methods. Data were obtained from TB case and CCT registries, and ME was performed using IS6110-based restriction fragment length polymorphism (RFLP) analysis and mycobacterial interspersed repetitive unit 12 (MIRU12) typing as a secondary typing method. During two years (2003 and 2004), 892 cases of TB were reported, of which 687 (77%) were confirmed by culture. RFLP analysis was performed with 463 (67.4%) of the 687 isolated strains, and MIRU12 types in 75 strains were evaluated; 280 strains (60.5%) had a unique RFLP pattern, and 183 (39.5%) shared patterns, grouping into 65 clusters. CCT of 613 (68.7%) of 892 cases detected 44 clusters involving 101 patients. The results of both CCT and ME methods yielded 96 clusters involving 255 patients. The household link was the one most frequently identified by CCT (corresponding to 80.7% of the cases clustered by this method), whereas nonhousehold and unknown links were associated with 94.1% of the strains clustered by ME. When both methods were used in 351 cases (39.3%), they showed the same results in 214 cases (61%). Of the remainder, 106 (30.2%) were clustered only by ME, 19 (5.5%) were clustered only by CCT, and 12 (3.4%) were clustered by both methods but into different clusters. Patients with factors potentially associated with social problems were less frequently studied by CCT (P ‫؍‬ 0.002), whereas patients of <15 years of age, most with negative cultures, were less frequently studied by ME (P ‫؍‬ 0.005). Significant differences in the populations studied by ME versus CCT were observed, possibly explaining the scarce correlation found between the results of these methods. Moreover, ME allowed the detection of nonhousehold contact relationships, whereas CCT was more useful for tracing transmission chains involving patients of <15 years of age. In conclusion, the two methods are complementary, suggesting the need to improve the methodology of contact study protocols.Tuberculosis (TB) continues to be one of the infectious diseases of greatest incidence in the world. In 2005, 8,811,000 cases were reported, with 1.6 million deaths (13). Although most cases occur in poor countries, in recent years an increase in cases in industrialized countries, favored by migratory movements, has been observed (14).TB is an airborne disease with a subacute or chronic clinical course. Among the control measures currently in use, the detection of new infections and secondary cases by conventional contact tracing (CCT) is fundamental (39). During the last 15 years, molecular epidemiology (ME) techniques have been demonstrated to be helpful in the study of TB transmission, and they have been applied to population studies (2,5,11,12,19,30), such as those of defined risk groups (22, 34) and analyses of outbreaks (6,20,21)....

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Factors Associated with Differences between Conventional Contact Tracing and Molecular Epidemiology in Study of Tuberculosis Transmission and Analysis in the City of Barcelona, Spain

et al. 2009

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“…Patients were grouped in the same cluster if their isolates were identical with respect to the number and size of hybridizing bands when six or more bands are present. 22 …”

Section: Epidemiological Characterizationmentioning

confidence: 99%

Molecular Analysis of Isoniazid and Rifampin Resistance inMycobacterium tuberculosisIsolates Recovered from Barcelona

Coll

Aragón²,

Alcaide³

et al. 2005

Microbial Drug Resistance

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We studied the presence of mutations in the whole katG gene and specific regions of the oxyR-ahpC and mabAinhA regulatory region in 61 Mycobacterium tuberculosis isoniazid-resistant isolates. An 81-bp region of the rpoB gene was also sequenced in 17 rifampin-resistant strains. Alterations in the katG gene were detected in 55% of the isolates. Mutation in codon 315 was the most prevalent (32%). Strains showed a high level of resistance, and most maintained a substantial catalase-peroxidase activity. Three strains with an isoniazid MIC of Ն32 g/ml lacked catalase-peroxidase activity. Two of them had deletions in the catalytic domain of the KatG protein. One strain with deletion and three strains with mutations in the C-terminal domain showed low-level resistance and conserved the catalase-peroxidase activity. Mutations in the mabA-inhA regulatory region were identified in 32% of the isolates. All had low-level resistance, and the vast majority conserved catalase-peroxidase activity. Seventeen percent of the isoniazid-resistant isolates had no detectable alterations at the studied loci. Resistance to rifampin was associated with mutations in the 81-bp of the rpoB gene in all cases. IS6110 analysis indicated that recent transmission contributed substantially to the emergence of isoniazid-resistant tuberculosis in Barcelona through short transmission chains. A rapid genotypic assay, including the 315-katG codon and the ؊15 nucleotide of the mabA-inhA regulatory region, may cover 62% of isoniazid-resistant strains in Barcelona. In contrast, the targeting of the 81-bp region of rpoB would detect all our rifampin-resistant isolates. 107

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“…The prison population is predominantly young and male with a low education level and prisoners usually originate from disadvantaged communities with high TB rates (March et al 2000). The prisoners usually live in unhealthy settings and do not have the resources or habits to keep themselves healthy.…”

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Tuberculosis in a southern Brazilian prison

Kuhleis

Ribeiro

Costa

et al. 2012

Mem. Inst. Oswaldo Cruz

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Predictors of tuberculosis transmission in prisons: an analysis using conventional and molecular methods

Cited by 34 publications

References 43 publications

Factors Associated with Differences between Conventional Contact Tracing and Molecular Epidemiology in Study of Tuberculosis Transmission and Analysis in the City of Barcelona, Spain

Factors Associated with Differences between Conventional Contact Tracing and Molecular Epidemiology in Study of Tuberculosis Transmission and Analysis in the City of Barcelona, Spain

Molecular Analysis of Isoniazid and Rifampin Resistance inMycobacterium tuberculosisIsolates Recovered from Barcelona

Tuberculosis in a southern Brazilian prison

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