Universal Genotyping in Tuberculosis Control Program, New York City, 2001–2003

Clark, Carla M.; Driver, Cynthia R.; Munsiff, Sonal S.; Driscoll, Jeffrey; Kreiswirth, Barry N.; Zhao, Benyang; Ebrahimzadeh, Adeleh; Salfinger, Max; Piatek, Amy S.; Abdelwahab, Jalaa’

doi:10.3201/eid1205.050446

Cited by 44 publications

(50 citation statements)

References 27 publications

(14 reference statements)

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“…MIRU-VNTR genotyping has been reported to identify as many clustered cases as RFLP genotyping (27), which led MIRU-VNTR-based genotyping to be chosen for the epidemiological survey in different institutions (5,8). However, in our study, MIRU-VNTR genotyping clustered isolates in a higher proportion than did RFLP genotyping.…”

Section: Discussionmentioning

confidence: 58%

“…MIRU-15 genotyping seems to be a good alternative to RFLP genotyping for real-time interventional schemes. The correlation between MIRU-15 and IS6110 RFLP findings was reasonable, although some uncertainties as to the assignation of clusters by MIRU-15 analysis were identified.Molecular tools have been widely used to characterize Mycobacterium tuberculosis isolates, with the aim of better understanding the epidemiology of tuberculosis (TB) (1,6,8,18,23). This has enabled us to document suspected outbreaks (4, 28, 34), identify risk factors associated with TB transmission (13,20,36), and evaluate the efficiency of control programs by observing the dynamics of clustered cases (9,12,17,22,24).…”

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confidence: 99%

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Prospective Universal Application of Mycobacterial Interspersed Repetitive-Unit-Variable-Number Tandem-Repeat Genotyping To CharacterizeMycobacterium tuberculosisIsolates for Fast Identification of Clustered and Orphan Cases

et al. 2009

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When discrepant cases showing subtle genotypic differences were tolerated, the discrepancies fell from 14.6% to 8.6%. Epidemiological links were found for 83.8% of the cases clustered by both RFLP and MIRU-15 analyses, whereas for the cases clustered by RFLP or MIRU-VNTR analysis alone, links were identified for only 30.8% or 38.9% of the cases, respectively. The latter group of cases mainly comprised isolates that could also have been clustered, if subtle genotypic differences had been tolerated. MIRU-15 genotyping seems to be a good alternative to RFLP genotyping for real-time interventional schemes. The correlation between MIRU-15 and IS6110 RFLP findings was reasonable, although some uncertainties as to the assignation of clusters by MIRU-15 analysis were identified.Molecular tools have been widely used to characterize Mycobacterium tuberculosis isolates, with the aim of better understanding the epidemiology of tuberculosis (TB) (1,6,8,18,23). This has enabled us to document suspected outbreaks (4, 28, 34), identify risk factors associated with TB transmission (13,20,36), and evaluate the efficiency of control programs by observing the dynamics of clustered cases (9,12,17,22,24).Restriction fragment length polymorphism (RFLP) analysis based on the IS6110 sequence is the reference genotyping method for M. tuberculosis (35). However, its limitations (mainly response times) make its adaptation unsuitable for real-time intervention epidemiological schemes. New genotyping techniques based on PCR have recently been developed and are more suitable for these purposes.One of the most promising PCR-based methods is mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) genotyping (21,(30)(31)(32). A novel format based on 15 loci has improved upon the initial 12-loci version. Its discriminatory power has been found to be equivalent to that of the standard approach on the basis of reference method, and its response time could be competitive. However, very few long-term analyses apply this technique universally in parallel to the reference method to identify advantages and pitfalls (1,25,27,33).In order to compare both techniques, we selected the province of Almería, in southeast Spain, because of the complexity of its socioepidemiological population profile, which challenges us to develop new and more-efficient methods of surveying TB transmission. In Almería, around 60% of the cases

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Section: Discussionmentioning

confidence: 58%

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confidence: 99%

Prospective Universal Application of Mycobacterial Interspersed Repetitive-Unit-Variable-Number Tandem-Repeat Genotyping To CharacterizeMycobacterium tuberculosisIsolates for Fast Identification of Clustered and Orphan Cases

et al. 2009

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“…Second, we found a low percentage of epidemiological links among clustered cases. This is a general limitation in molecular epidemiological studies (4,9). In our study, although tuberculosis case registry and contact tracing information were examined, we did not carry out moredetailed interviews for all clustered cases than what is done routinely.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Changes in Recent Tuberculosis Transmission Patterns after a Sharp Increase in Immigration

et al. 2007

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We conducted a population-based molecular epidemiological study of tuberculosis (TB) in Madrid, Spain (2002 to 2004), to define transmission patterns and factors associated with clustering. We particularly focused on examining how the increase in TB cases among immigrants in recent years (2.8% in 1997 to 1999 to 36.2% during the current study) was modifying transmission patterns. Mycobacterium tuberculosis isolates obtained from patients living in nine districts of Madrid (1,459,232 inhabitants) were genotyped. The TB case rate among foreign-born people was three to four times that of Spanish-born people, and the median time from arrival to the onset of treatment was 22.4 months. During the study period, 227 (36.3%) patients were grouped in 64 clusters, and 115 (50.7%) of them were in 21 clusters with mixed Spanish-born and foreign-born patients. Three of the 21 mixed clusters accounted for 21.1% of clustered patients. Twenty-two of 38 (57.9%) immigrants in mixed clusters were infected with TB strains that had already been identified in the native population in 1997 to 1999, including the three most prevalent strains. Factors identified as independent predictors of clustering were homelessness (odds ratio [OR], 2.3; 95% confidence interval [95% CI], 1.2 to 4.5; P ‫؍‬ 0.011) and to be born in Spain (OR, 1.8; 95% CI, 1.2 to 2.6; P ‫؍‬ 0.002). The results indicated that (i) TB transmission was higher in Spanish-born people, associated mainly with homelessness, (ii) that foreign-born people were much less likely to be clustered, suggesting a higher percentage of infection before arriving in Spain, and (iii) that an extensive transmission between Spanish-and foreign-born populations, caused mainly by autochthonous strains, was taking place in Madrid.

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“…Before 2001, genotyping was performed on isolates from selected TB patients. 11 For purposes of this analysis, genotype results were defined as concordant between members of a case-pair if RFLP and spoligotype patterns matched exactly or if the RFLP patterns matched exactly but spoligotype results were unavailable. To account for the possibility of spontaneous bacterial mutation events before or after transmission, genotype results were also considered concordant if no more than a one-band RFLP difference existed between case-pair isolates (i.e., near-match) that had exactly matching spoligotype patterns and when subsequent review by the genotyping laboratory confirmed the plausibility of direct transmission on the basis of RFLP pattern similarity.…”

Section: Data Analysis and Statistical Methodsmentioning

confidence: 99%

Risk for Tuberculosis Disease Among Contacts with Prior Positive Tuberculin Skin Test: A retrospective Cohort Study, New York City

et al. 2015

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Universal Genotyping in Tuberculosis Control Program, New York City, 2001–2003

Abstract: Real-time universal genotyping decreased unnecessary treatment.

Cited by 44 publications

References 27 publications

Prospective Universal Application of Mycobacterial Interspersed Repetitive-Unit-Variable-Number Tandem-Repeat Genotyping To CharacterizeMycobacterium tuberculosisIsolates for Fast Identification of Clustered and Orphan Cases

Prospective Universal Application of Mycobacterial Interspersed Repetitive-Unit-Variable-Number Tandem-Repeat Genotyping To CharacterizeMycobacterium tuberculosisIsolates for Fast Identification of Clustered and Orphan Cases

Analysis of Changes in Recent Tuberculosis Transmission Patterns after a Sharp Increase in Immigration

Risk for Tuberculosis Disease Among Contacts with Prior Positive Tuberculin Skin Test: A retrospective Cohort Study, New York City

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