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2. Differentiation of tuberculosis strains in a population with mainly Beijing-family strains.

Author

Nikolayevskyy V, Gopaul K, Balabanova Y, Brown T, Fedorin I, and Drobniewski F

Subjects
Adult, DNA, Bacterial analysis, Female, Genotype, Humans, Male, Middle Aged, Molecular Epidemiology, Mycobacterium tuberculosis genetics, Mycobacterium tuberculosis isolation & purification, Russia epidemiology, Bacterial Typing Techniques methods, Minisatellite Repeats genetics, Mycobacterium tuberculosis classification, Tuberculosis, Pulmonary epidemiology, Tuberculosis, Pulmonary microbiology
Abstract

A high prevalence of tuberculosis (TB) isolates that are genetically homogenous and from the Beijing family has been reported in Russia. To map TB transmission caused by these strains, new genotyping systems are needed. Mycobacterial interspersed repetitive units (MIRUs) offer the possibility of rapid PCR-based typing with comparable discrimination to IS6110 restriction fragment length polymorphism techniques. Spoligotyping and detection of IS6110 insertion in the dnaA-dnaN region were used to identify Beijing strains in 187 Mycobacterium tuberculosis isolates from Samara, Russia. The Beijing isolates were analyzed by using 12-MIRU and 3-exact tandem repeats (ETR) loci and by an expanded set of 10 additional variable number tandem repeats loci. The expanded set of 25 MIRUs provided better discrimination than the original set of 15 (Hunter-Gaston diversity index 0.870 vs. 0.625). Loci MIRU 26, 1982, and 3232 were the most polymorphic in Beijing isolates.

Published
2006
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3. Molecular epidemiology of tuberculosis in England, 1998

Author

Love J, Sonnenberg P, Jr, Glynn, Gibson A, Gopaul K, Fang Z, Le Brun F, Pitman R, Ac, Hayward, Innes J, Van den Bosch C, valerie delpech, Drobniewski F, and Jm, Watson

Subjects
Adult, Lung Diseases, Male, Molecular Epidemiology, Adolescent, Infant, Newborn, Infant, Comorbidity, Mycobacterium tuberculosis, History, 20th Century, Middle Aged, Bacterial Typing Techniques, Young Adult, England, Risk Factors, Child, Preschool, Ill-Housed Persons, Cluster Analysis, Humans, Tuberculosis, Female, Child, Polymorphism, Restriction Fragment Length
Abstract

England.To investigate the proportion of tuberculosis (TB) cases attributable to recent transmission and factors associated with clustering.Demographic, clinical and microbiological surveillance data were collated from all new culture-confirmed cases in 1998. Using insertion sequence (IS) 6110 restriction fragment length polymorphism (RFLP) typing, strains were classified as clustered (identical patterns) or unique and risk factors were determined using multivariable logistic regression.RFLP patterns were available for 2265 of 3713 (61%) cases: 1808 hador=5 IS6110 copies, while 372 cases were in 152 clusters, giving an estimated proportion due to recent transmission of 12.2%.Pulmonary disease (aOR 1.6; 95%CI 1.1-2.2), previous treatment (aOR 3.7; 2.2-6.5) and homelessness (aOR 5.5; 1.2-24.1) were independent risk factors for clustering. Fourteen per cent of patients of Indian subcontinent origin were clustered compared with 27% of white patients. Many clusters spanned ethnic groups (45%) and geographical regions (47%).The calculated proportion of TB cases due to recent transmission is low.Adjusting for missed cases and study duration, it increases to 27.6%. Many cases may arise from reactivation or acquisition outside England. Transmission within England accounted for approximately one in four cases and occurred over wide geographic areas, between ethnic groups and among the homeless. Molecular epidemiology can inform local and national public health action.

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