Transmission permeability of tuberculosis involving immigrants, revealed by a multicentre analysis of clusters

Rodríguez, N. Alonso; Andrés, Sandra; Bouza, Emilio; Herránz, Marta; Serrano, Manuel Nistal Martín; Viedma, Darío García de; Palenque, Elia; Cháves, Fernando; Íñigo, Jesús; Cías, R.; Daza, Roberto; Domingo, Diego; Esteban, Jaime; Bobes, Julio; Mampaso, E. Gómez

doi:10.1111/j.1469-0691.2008.02670.x

Cited by 28 publications

(20 citation statements)

References 21 publications

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“…Nineteen percent of the immigrant clusters (involving 42.5% of the MTB isolates) were found to be large and most of these were multinational and/or mixed, consistent with the high transmission permeability identified in Madrid [15].…”

Section: Discussionsupporting

confidence: 53%

“…Recent studies in Spain have revealed that, in addition to immigrant tuberculosis (TB) cases that appear to have been imported, a proportion of immigrant TB cases are caused by recent transmission after arrival in the host country [9,[13][14][15]. In this situation, the specific analysis of immigrant clusters, especially large clusters, deserves attention.…”

Section: Introductionmentioning

confidence: 99%

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Differences in the robustness of clusters involving the Mycobacterium tuberculosis strains most frequently isolated from immigrant cases in Madrid

Rodríguez

Lirola

Cháves

et al. 2010

Clinical Microbiology and Infection

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Tuberculosis cases infected by the same Mycobacterium tuberculosis (MTB) strain are considered to be clustered and involved in a transmission chain. Large clusters are assumed to represent active transmission chains in a population. In the present study, we focused on the analysis of large clusters defined by IS6110-restriction fragment length polymorphism (RFLP) typing in the immigrant population in Madrid. We identified 12 large clusters (involving 43% of the isolates) comprising 4-23 representatives. We proposed a gradient of epidemiological certainty for these large clusters. For a cluster to be considered robust and a good indicator of recent transmission, the MTB strain involved should not have been identified in a geographically and epidemiologically unrelated population and the cluster had to be re-confirmed by another highly discriminative molecular marker (MIRU-VNTR). The clusters that we discovered were classified into three categories: high, intermediate and low expected epidemiological value. In the largest cluster in the study (cluster M6; 23 representatives), failures by both criteria were identified: the representative seven-band RFLP pattern was also the most prevalent in the unrelated population (25 cases) and the cluster was fully split by MIRU-15, suggesting a lack of epidemiological value. The RFLP pattern representative of this cluster was also identified in 64 isolates from five countries in the Latin American genotype database, and again proved to be heterogeneous according to the MIRU-15 analysis. Specific analysis of large clusters, combined with the application of criteria for evaluating their robustness, could help identify uninformative clusters and target epidemiological resources towards those clusters with higher expected epidemiological value.

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Section: Discussionsupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Differences in the robustness of clusters involving the Mycobacterium tuberculosis strains most frequently isolated from immigrant cases in Madrid

Rodríguez

Lirola

Cháves

et al. 2010

Clinical Microbiology and Infection

Self Cite

View full text Add to dashboard Cite

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“…Traditionally, reactiva-tion TB was thought to be the cause of active TB in immigrants who originated from areas with high TB prevalences and who are now living in countries with low TB prevalences (26). However, cluster analyses in Spain suggested that recent transmission can be a significant cause of TB infections in immigrants (11,174). While immigration can influence the dynamics of the HIV-TB syndemic, its effect is less marked than that of the smaller-scale internal migration of selected high-risk populations, such as migrant workers in South Africa.…”

Section: Population Mobility Can Shape the Dynamics Of Transmission Omentioning

confidence: 99%

HIV and Tuberculosis: a Deadly Human Syndemic

2011

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SUMMARY A syndemic is defined as the convergence of two or more diseases that act synergistically to magnify the burden of disease. The intersection and syndemic interaction between the human immunodeficiency virus (HIV) and tuberculosis (TB) epidemics have had deadly consequences around the world. Without adequate control of the TB-HIV syndemic, the long-term TB elimination target set for 2050 will not be reached. There is an urgent need for additional resources and novel approaches for the diagnosis, treatment, and prevention of both HIV and TB. Moreover, multidisciplinary approaches that consider HIV and TB together, rather than as separate problems and diseases, will be necessary to prevent further worsening of the HIV-TB syndemic. This review examines current knowledge of the state and impact of the HIV-TB syndemic and reviews the epidemiological, clinical, cellular, and molecular interactions between HIV and TB.

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“…The database used in the survey included the genotypes of the M. tuberculosis isolates from 2,669 cases. These were obtained from a multicenter molecular epidemiology study performed over 9 years in Madrid (2001 to 2009) and involving 8 hospitals (19)(20)(21). The sample corresponded to 79% and 32% of all culture-positive cases in immigrants and autochthonous patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

Persistent Infection by a Mycobacterium tuberculosis Strain That Was Theorized To Have Advantageous Properties, as It Was Responsible for a Massive Outbreak

et al. 2015

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The strains involved in tuberculosis outbreaks are considered highly virulent and transmissible. We analyzed the case of a patient in Madrid, Spain, who was persistently infected over an 8-year period by the same Beijing Mycobacterium tuberculosis strain. The strain was responsible for a severe outbreak on Gran Canaria Island. The case provides us with a unique opportunity to challenge our assumptions about M. tuberculosis Beijing strains. No clinical/radiological findings consistent with a virulent strain were documented, and the in vitro growth rate of the strain in macrophages was only moderate. No secondary cases stemming from this prolonged active case were detected in the host population. The strain did not acquire resistance mutations, despite constant treatment interruptions, and it remained extremely stable, as demonstrated by the lack of single-nucleotide-polymorphism (SNP)-based differences between the sequential isolates. Our data suggest that the general assumption about M. tuberculosis Beijing strains having advantageous properties (in terms of virulence, transmissibility, and the tendency to acquire mutations and resistance) is not always accurate.

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Transmission permeability of tuberculosis involving immigrants, revealed by a multicentre analysis of clusters

Cited by 28 publications

References 21 publications

Differences in the robustness of clusters involving the Mycobacterium tuberculosis strains most frequently isolated from immigrant cases in Madrid

Differences in the robustness of clusters involving the Mycobacterium tuberculosis strains most frequently isolated from immigrant cases in Madrid

HIV and Tuberculosis: a Deadly Human Syndemic

Persistent Infection by a Mycobacterium tuberculosis Strain That Was Theorized To Have Advantageous Properties, as It Was Responsible for a Massive Outbreak

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