1
|
Country-wide genotyping of Mycobacterium tuberculosis complex in Singapore, 2011–2017. Tuberculosis (Edinb) 2022; 134:102204. [DOI: 10.1016/j.tube.2022.102204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 11/18/2022]
|
2
|
Winter JR, Smith CJ, Davidson JA, Lalor MK, Delpech V, Abubakar I, Stagg HR. The impact of HIV infection on tuberculosis transmission in a country with low tuberculosis incidence: a national retrospective study using molecular epidemiology. BMC Med 2020; 18:385. [PMID: 33308204 PMCID: PMC7734856 DOI: 10.1186/s12916-020-01849-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 11/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND HIV is known to increase the likelihood of reactivation of latent tuberculosis to active TB disease; however, its impact on tuberculosis infectiousness and consequent transmission is unclear, particularly in low-incidence settings. METHODS National surveillance data from England, Wales and Northern Ireland on tuberculosis cases in adults from 2010 to 2014, strain typed using 24-locus mycobacterial-interspersed-repetitive-units-variable-number-tandem-repeats was used retrospectively to identify clusters of tuberculosis cases, subdivided into 'first' and 'subsequent' cases. Firstly, we used zero-inflated Poisson regression models to examine the association between HIV status and the number of subsequent clustered cases (a surrogate for tuberculosis infectiousness) in a strain type cluster. Secondly, we used logistic regression to examine the association between HIV status and the likelihood of being a subsequent case in a cluster (a surrogate for recent acquisition of tuberculosis infection) compared to the first case or a non-clustered case (a surrogate for reactivation of latent infection). RESULTS We included 18,864 strain-typed cases, 2238 were the first cases of clusters and 8471 were subsequent cases. Seven hundred and fifty-nine (4%) were HIV-positive. Outcome 1: HIV-positive pulmonary tuberculosis cases who were the first in a cluster had fewer subsequent cases associated with them (mean 0.6, multivariable incidence rate ratio [IRR] 0.75 [0.65-0.86]) than those HIV-negative (mean 1.1). Extra-pulmonary tuberculosis (EPTB) cases with HIV were less likely to be the first case in a cluster compared to HIV-negative EPTB cases. EPTB cases who were the first case had a higher mean number of subsequent cases (mean 2.5, IRR (3.62 [3.12-4.19]) than those HIV-negative (mean 0.6). Outcome 2: tuberculosis cases with HIV co-infection were less likely to be a subsequent case in a cluster (odds ratio 0.82 [0.69-0.98]), compared to being the first or a non-clustered case. CONCLUSIONS Outcome 1: pulmonary tuberculosis-HIV patients were less infectious than those without HIV. EPTB patients with HIV who were the first case in a cluster had a higher number of subsequent cases and thus may be markers of other undetected cases, discoverable by contact investigations. Outcome 2: tuberculosis in HIV-positive individuals was more likely due to reactivation than recent infection, compared to those who were HIV-negative.
Collapse
Affiliation(s)
- Joanne R Winter
- Institute for Global Health, University College London, London, UK
| | - Colette J Smith
- Institute for Global Health, University College London, London, UK
| | - Jennifer A Davidson
- Tuberculosis Unit, National Infection Service, Public Health England, London, UK
| | - Maeve K Lalor
- Tuberculosis Unit, National Infection Service, Public Health England, London, UK
| | - Valerie Delpech
- HIV Unit, National Infection Service, Public Health England, London, UK
| | - Ibrahim Abubakar
- Institute for Global Health, University College London, London, UK.
| | - Helen R Stagg
- Institute for Global Health, University College London, London, UK.,Usher Institute, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
3
|
Gafar F, Ochi T, Van't Boveneind-Vrubleuskaya N, Akkerman OW, Erkens C, van den Hof S, van der Werf TS, Alffenaar JWC, Wilffert B. Towards elimination of childhood and adolescent tuberculosis in the Netherlands: an epidemiological time-series analysis of national surveillance data. Eur Respir J 2020; 56:13993003.01086-2020. [PMID: 32471938 DOI: 10.1183/13993003.01086-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/22/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Tuberculosis (TB) in children and adolescents is a sentinel event for ongoing transmission. In the Netherlands, epidemiological characteristics of childhood and adolescent TB have not been fully evaluated. Therefore, we aimed to assess TB epidemiology within this population to provide guidance for TB elimination. METHODS A retrospective time-series analysis using national surveillance data from 1993-2018 was performed in children (aged <15 years) and adolescents (aged 15-19 years) with TB. Poisson regression models offset with log-population size were used to estimate notification rates and rate ratios. Trends in notification rates were estimated using average annual percentage changes (AAPC) based on the segmented linear regression analysis. RESULTS Among 3899 children and adolescents with TB notified during 1993-2018, 2418 (62%) were foreign-born (725 (41.3%) out of 1755 children and 1693 (78.9%) out of 2144 adolescents). The overall notification rate in children was 2.3 per 100 000 person-years, declining steadily during the study period (AAPC -10.9%, 95% CI -12.6--9.1). In adolescents, the overall notification rate was 8.4 per 100 000 person-years, strongly increasing during 1993-2001 and 2012-2018. Compared to Dutch-born children and adolescents, substantially higher notification rates were observed among African-born children and adolescents (116.8 and 316.6 per 100 000 person-years, respectively). Additionally, an increasing trend was observed in African-born adolescents (AAPC 18.5%, 95% CI 11.9-25.5). Among the foreign-born population, those from countries in the horn of Africa contributed most to the TB caseload. CONCLUSION TB notification rate among children was low and constantly declining across different demographic groups. However, heterogeneities were shown in adolescents, with an increasing trend in the foreign-born, particularly those from Africa.
Collapse
Affiliation(s)
- Fajri Gafar
- University of Groningen, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology, and Economics, Groningen, The Netherlands
| | - Taichi Ochi
- University of Groningen, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology, and Economics, Groningen, The Netherlands
| | - Natasha Van't Boveneind-Vrubleuskaya
- University of Groningen, University Medical Center Groningen, Dept of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands.,Dept of Public Health TB Control, Metropolitan Public Health Services, The Hague, The Netherlands
| | - Onno W Akkerman
- University of Groningen, University Medical Center Groningen, Dept of Pulmonary Diseases and Tuberculosis, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Tuberculosis Center Beatrixoord, Haren, The Netherlands
| | - Connie Erkens
- KNCV Tuberculosis Foundation, The Hague, The Netherlands
| | - Susan van den Hof
- National Institute for Public Health and the Environment, Centre for Infectious Disease Control, Bilthoven, The Netherlands
| | - Tjip S van der Werf
- University of Groningen, University Medical Center Groningen, Dept of Pulmonary Diseases and Tuberculosis, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Dept of Internal Medicine, Groningen, The Netherlands
| | - Jan-Willem C Alffenaar
- University of Groningen, University Medical Center Groningen, Dept of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands.,University of Sydney, Faculty of Medicine and Health, School of Pharmacy, Sydney, Australia.,Westmead Hospital, Sydney, Australia.,Marie Bashir Institute of Infectious Diseases, University of Sydney, Sydney, Australia
| | - Bob Wilffert
- University of Groningen, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology, and Economics, Groningen, The Netherlands.,University of Groningen, University Medical Center Groningen, Dept of Clinical Pharmacy and Pharmacology, Groningen, The Netherlands
| |
Collapse
|
4
|
Izumi K, Murase Y, Uchimura K, Kaebeta A, Ishihara K, Kaguraoka S, Takii T, Ohkado A. Transmission of tuberculosis and predictors of large clusters within three years in an urban setting in Tokyo, Japan: a population-based molecular epidemiological study. BMJ Open 2019; 9:e029295. [PMID: 31076478 PMCID: PMC6527980 DOI: 10.1136/bmjopen-2019-029295] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Molecular epidemiology is a promising tool for understanding tuberculosis transmission dynamics but has not been sufficiently utilised in Asian countries including Japan. The aim of this study was to estimate the proportion of TB cases attributable to recent transmission and to identify risk factors of genotype clustering and the development of large clusters within 3 years in an urban setting in Japan. DESIGN AND SETTING Long-term cross-sectional observational study combining the characteristics of patients with culture-positive TB notified in Shinjuku City, Tokyo (2002-2013), with genotype data of Mycobacterium tuberculosis. PRIMARY OUTCOME MEASURE: Genotype clustering rate and association between genotype clustering status and explanatory variables. RESULTS Among 1025 cases, 515 were localised within 113 genotype clusters. The overall clustering rate was 39.2%. Significantly higher rates were found in patients aged <40 years (adjusted odds ratio (aOR)=1.73, 95% CI 1.23 to 2.44), native Japanese individuals (aOR=3.90, 95% CI 2.27 to 6.72), full-time workers (aOR=1.63, 95% CI 1.17 to 2.27), part-time/daily workers (aOR=2.20, 95% CI 1.35 to 3.58), individuals receiving public assistance (aOR=1.81, 95% CI 1.15 to 2.84) and homeless people (aOR=1.63, 95% CI 1.02 to 2.62). A significant predictor of large genotype clusters within 3 years was a registration interval ≤2 months between the first two cases in a cluster. CONCLUSION Our results indicated that a large proportion of patients with culture-positive TB were involved in the recent TB transmission chain. Foreign-born persons still have a limited impact on transmission in the Japanese urban setting. Intensified public health interventions, including the active case finding, need to focus on individuals with socioeconomic risk factors that are significantly associated with tuberculosis transmission and clusters with shorter registration intervals between the first two cases.
Collapse
Affiliation(s)
- Kiyohiko Izumi
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Kiyose, Japan
| | - Yoshiro Murase
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Kiyose, Japan
| | - Kazuhiro Uchimura
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Kiyose, Japan
| | - Aya Kaebeta
- Health Department, Shinjuku Public Health Center, Shinjuku, Japan
| | - Keiko Ishihara
- Health Department, Shinjuku Public Health Center, Shinjuku, Japan
| | - Sumi Kaguraoka
- Health Department, Shinjuku Public Health Center, Shinjuku, Japan
| | - Takemasa Takii
- Department of Mycobacterium Reference and Research, The Research Institute of Tuberculosis, Kiyose, Japan
| | - Akihiro Ohkado
- Department of Epidemiology and Clinical Research, The Research Institute of Tuberculosis, Kiyose, Japan
| |
Collapse
|
5
|
Blanco-Guillot F, Delgado-Sánchez G, Mongua-Rodríguez N, Cruz-Hervert P, Ferreyra-Reyes L, Ferreira-Guerrero E, Yanes-Lane M, Montero-Campos R, Bobadilla-del-Valle M, Torres-González P, Ponce-de-León A, Sifuentes-Osornio J, Garcia-Garcia L. Molecular clustering of patients with diabetes and pulmonary tuberculosis: A systematic review and meta-analysis. PLoS One 2017; 12:e0184675. [PMID: 28902922 PMCID: PMC5597214 DOI: 10.1371/journal.pone.0184675] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 08/24/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction Many studies have explored the relationship between diabetes mellitus (DM) and tuberculosis (TB) demonstrating increased risk of TB among patients with DM and poor prognosis of patients suffering from the association of DM/TB. Owing to a paucity of studies addressing this question, it remains unclear whether patients with DM and TB are more likely than TB patients without DM to be grouped into molecular clusters defined according to the genotype of the infecting Mycobacterium tuberculosis bacillus. That is, whether there is convincing molecular epidemiological evidence for TB transmission among DM patients. Objective: We performed a systematic review and meta-analysis to quantitatively evaluate the propensity for patients with DM and pulmonary TB (PTB) to cluster according to the genotype of the infecting M. tuberculosis bacillus. Materials and methods We conducted a systematic search in MEDLINE and LILACS from 1990 to June, 2016 with the following combinations of key words “tuberculosis AND transmission” OR “tuberculosis diabetes mellitus” OR “Mycobacterium tuberculosis molecular epidemiology” OR “RFLP-IS6110” OR “Spoligotyping” OR “MIRU-VNTR”. Studies were included if they met the following criteria: (i) studies based on populations from defined geographical areas; (ii) use of genotyping by IS6110- restriction fragment length polymorphism (RFLP) analysis and spoligotyping or mycobacterial interspersed repetitive unit-variable number of tandem repeats (MIRU-VNTR) or other amplification methods to identify molecular clustering; (iii) genotyping and analysis of 50 or more cases of PTB; (iv) study duration of 11 months or more; (v) identification of quantitative risk factors for molecular clustering including DM; (vi) > 60% coverage of the study population; and (vii) patients with PTB confirmed bacteriologically. The exclusion criteria were: (i) Extrapulmonary TB; (ii) TB caused by nontuberculous mycobacteria; (iii) patients with PTB and HIV; (iv) pediatric PTB patients; (v) TB in closed environments (e.g. prisons, elderly homes, etc.); (vi) diabetes insipidus and (vii) outbreak reports. Hartung-Knapp-Sidik-Jonkman method was used to estimate the odds ratio (OR) of the association between DM with molecular clustering of cases with TB. In order to evaluate the degree of heterogeneity a statistical Q test was done. The publication bias was examined with Begg and Egger tests. Review Manager 5.3.5 CMA v.3 and Biostat and Software package R were used. Results Selection criteria were met by six articles which included 4076 patients with PTB of which 13% had DM. Twenty seven percent of the cases were clustered. The majority of cases (48%) were reported in a study in China with 31% clustering. The highest incidence of TB occurred in two studies from China. The global OR for molecular clustering was 0.84 (IC 95% 0.40–1.72). The heterogeneity between studies was moderate (I2 = 55%, p = 0.05), although there was no publication bias (Beggs test p = 0.353 and Eggers p = 0.429). Conclusion There were very few studies meeting our selection criteria. The wide confidence interval indicates that there is not enough evidence to draw conclusions about the association. Clustering of patients with DM in TB transmission chains should be investigated in areas where both diseases are prevalent and focus on specific contexts.
Collapse
Affiliation(s)
- Francles Blanco-Guillot
- Doctorado en Ciencias en Enfermedades Infecciosas, Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Guadalupe Delgado-Sánchez
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Norma Mongua-Rodríguez
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- Maestría en Ciencias Médicas con énfasis en Epidemiología, Facultad de Medicina, Universidad Nacional Autónoma de México, Distrito Federal, México
| | - Pablo Cruz-Hervert
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Leticia Ferreyra-Reyes
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Elizabeth Ferreira-Guerrero
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Mercedes Yanes-Lane
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, San Luis Potosí, México
| | - Rogelio Montero-Campos
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - Miriam Bobadilla-del-Valle
- Laboratorio de Microbiología, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, México, Distrito Federal, México
| | - Pedro Torres-González
- Laboratorio de Microbiología, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, México, Distrito Federal, México
| | - Alfredo Ponce-de-León
- Laboratorio de Microbiología, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, México, Distrito Federal, México
| | - José Sifuentes-Osornio
- Dirección Médica, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, México, Distrito Federal, México
| | - Lourdes Garcia-Garcia
- Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
- * E-mail:
| |
Collapse
|
6
|
Nebenzahl-Guimaraes H, van Laarhoven A, Farhat MR, Koeken VACM, Mandemakers JJ, Zomer A, van Hijum SAFT, Netea MG, Murray M, van Crevel R, van Soolingen D. Transmissible Mycobacterium tuberculosis Strains Share Genetic Markers and Immune Phenotypes. Am J Respir Crit Care Med 2017; 195:1519-1527. [PMID: 27997216 DOI: 10.1164/rccm.201605-1042oc] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
RATIONALE Successful transmission of tuberculosis depends on the interplay of human behavior, host immune responses, and Mycobacterium tuberculosis virulence factors. Previous studies have been focused on identifying host risk factors associated with increased transmission, but the contribution of specific genetic variations in mycobacterial strains themselves are still unknown. OBJECTIVES To identify mycobacterial genetic markers associated with increased transmissibility and to examine whether these markers lead to altered in vitro immune responses. METHODS Using a comprehensive tuberculosis registry (n = 10,389) and strain collection in the Netherlands, we identified a set of 100 M. tuberculosis strains either least or most likely to be transmitted after controlling for host factors. We subjected these strains to whole-genome sequencing and evolutionary convergence analysis, and we repeated this analysis in an independent validation cohort. We then performed immunological experiments to measure in vitro cytokine production and neutrophil responses to a subset of the original strains with or without the identified mutations associated with increased transmissibility. MEASUREMENTS AND MAIN RESULTS We identified the loci espE, PE-PGRS56, Rv0197, Rv2813-2814c, and Rv2815-2816c as targets of convergent evolution among transmissible strains. We validated four of these regions in an independent set of strains, and we demonstrated that mutations in these targets affected in vitro monocyte and T-cell cytokine production, neutrophil reactive oxygen species release, and apoptosis. CONCLUSIONS In this study, we identified genetic markers in convergent evolution of M. tuberculosis toward enhanced transmissibility in vivo that are associated with altered immune responses in vitro.
Collapse
Affiliation(s)
- Hanna Nebenzahl-Guimaraes
- 1 National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,2 Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,3 ICVS/3B's Research Group, PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Arjan van Laarhoven
- 4 Department of Internal Medicine and Radboud Center for Infectious Diseases
| | - Maha R Farhat
- 5 Pulmonary and Critical Care Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | | | | | - Aldert Zomer
- 7 Center for Molecular and Biomolecular Informatics, Radboud Institute for Molecular Life Sciences, and.,8 Department of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Sacha A F T van Hijum
- 7 Center for Molecular and Biomolecular Informatics, Radboud Institute for Molecular Life Sciences, and
| | - Mihai G Netea
- 4 Department of Internal Medicine and Radboud Center for Infectious Diseases
| | - Megan Murray
- 9 Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts; and.,10 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Reinout van Crevel
- 4 Department of Internal Medicine and Radboud Center for Infectious Diseases
| | - Dick van Soolingen
- 1 National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,11 Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, the Netherlands
| |
Collapse
|
7
|
Hamblion EL, Le Menach A, Anderson LF, Lalor MK, Brown T, Abubakar I, Anderson C, Maguire H, Anderson SR. Recent TB transmission, clustering and predictors of large clusters in London, 2010-2012: results from first 3 years of universal MIRU-VNTR strain typing. Thorax 2017; 71:749-56. [PMID: 27417280 PMCID: PMC4975838 DOI: 10.1136/thoraxjnl-2014-206608] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 02/12/2016] [Indexed: 11/29/2022]
Abstract
Background The incidence of TB has doubled in the last 20 years in London. A better understanding of risk groups for recent transmission is required to effectively target interventions. We investigated the molecular epidemiological characteristics of TB cases to estimate the proportion of cases due to recent transmission, and identify predictors for belonging to a cluster. Methods The study population included all culture-positive TB cases in London residents, notified between January 2010 and December 2012, strain typed using 24-loci multiple interspersed repetitive units-variable number tandem repeats. Multivariable logistic regression analysis was performed to assess the risk factors for clustering using sociodemographic and clinical characteristics of cases and for cluster size based on the characteristics of the first two cases. Results There were 10 147 cases of which 5728 (57%) were culture confirmed and 4790 isolates (84%) were typed. 2194 (46%) were clustered in 570 clusters, and the estimated proportion attributable to recent transmission was 34%. Clustered cases were more likely to be UK born, have pulmonary TB, a previous diagnosis, a history of substance abuse or alcohol abuse and imprisonment, be of white, Indian, black-African or Caribbean ethnicity. The time between notification of the first two cases was more likely to be <90 days in large clusters. Conclusions Up to a third of TB cases in London may be due to recent transmission. Resources should be directed to the timely investigation of clusters involving cases with risk factors, particularly those with a short period between the first two cases, to interrupt onward transmission of TB.
Collapse
Affiliation(s)
- Esther L Hamblion
- Field Epidemiology Services (Victoria), Public Health England, London, UK
| | - Arnaud Le Menach
- Field Epidemiology Services (Victoria), Public Health England, London, UK European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Control and Prevention, Stockholm, Sweden
| | - Laura F Anderson
- Tuberculosis Section, Respiratory Disease Department, Public Health England, London, UK
| | - Maeve K Lalor
- Tuberculosis Section, Respiratory Disease Department, Public Health England, London, UK
| | - Tim Brown
- National Mycobacterium Reference Laboratory, Institute of Cell and Molecular Science (ICMS), London, UK
| | - Ibrahim Abubakar
- Tuberculosis Section, Respiratory Disease Department, Public Health England, London, UK Centre for Infectious Disease Epidemiology, University College London, Mortimer Market Centre, London, UK
| | - Charlotte Anderson
- Field Epidemiology Services (Victoria), Public Health England, London, UK
| | - Helen Maguire
- Field Epidemiology Services (Victoria), Public Health England, London, UK European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Control and Prevention, Stockholm, Sweden
| | - Sarah R Anderson
- Field Epidemiology Services (Victoria), Public Health England, London, UK
| | | |
Collapse
|
8
|
Fiebig L, Kohl TA, Popovici O, Mühlenfeld M, Indra A, Homorodean D, Chiotan D, Richter E, Rüsch-Gerdes S, Schmidgruber B, Beckert P, Hauer B, Niemann S, Allerberger F, Haas W. A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria, Romania and Germany in 2014 using classic, genotyping and whole genome sequencing methods: lessons learnt. ACTA ACUST UNITED AC 2017; 22:30439. [PMID: 28106529 PMCID: PMC5404487 DOI: 10.2807/1560-7917.es.2017.22.2.30439] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 09/28/2016] [Indexed: 11/30/2022]
Abstract
Molecular surveillance of multidrug-resistant tuberculosis (MDR-TB) using 24-loci MIRU-VNTR in the European Union suggests the occurrence of international transmission. In early 2014, Austria detected a molecular MDR-TB cluster of five isolates. Links to Romania and Germany prompted the three countries to investigate possible cross-border MDR-TB transmission jointly. We searched genotyping databases, genotyped additional isolates from Romania, used whole genome sequencing (WGS) to infer putative transmission links, and investigated pairwise epidemiological links and patient mobility. Ten isolates from 10 patients shared the same 24-loci MIRU-VNTR pattern. Within this cluster, WGS defined two subgroups of four patients each. The first comprised an MDR-TB patient from Romania who had sought medical care in Austria and two patients from Austria. The second comprised patients, two of them epidemiologically linked, who lived in three different countries but had the same city of provenance in Romania. Our findings strongly suggested that the two cases in Austrian citizens resulted from a newly introduced MDR-TB strain, followed by domestic transmission. For the other cases, transmission probably occurred in the same city of provenance. To prevent further MDR-TB transmission, we need to ensure universal access to early and adequate therapy and collaborate closely in tuberculosis care beyond administrative borders.
Collapse
Affiliation(s)
- Lena Fiebig
- Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.,These authors contributed equally to this work
| | - Thomas A Kohl
- These authors contributed equally to this work.,Molecular and Experimental Mycobacteriology, Research Center Borstel, Leibniz-Center for Medicine and Biosciences, Borstel, Germany
| | - Odette Popovici
- National Institute of Public Health - National Center for Communicable Diseases Surveillance and Control, Bucharest, Romania
| | | | - Alexander Indra
- Austrian Reference Laboratory for Mycobacteria, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Daniela Homorodean
- Clinical Hospital of Pneumology, Tuberculosis National Reference Laboratory, Cluj-Napoca, Romania
| | | | | | - Sabine Rüsch-Gerdes
- National Reference Center (NRC) for Mycobacteria, Research Center Borstel, Borstel, Germany
| | - Beatrix Schmidgruber
- Tuberculosis Patient Service, Health Service of the City of Vienna, Vienna, Austria
| | - Patrick Beckert
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Leibniz-Center for Medicine and Biosciences, Borstel, Germany.,German Center for Infection Research, Partner Site Hamburg-Borstel-Lübeck, Borstel, Germany
| | - Barbara Hauer
- Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Stefan Niemann
- Molecular and Experimental Mycobacteriology, Research Center Borstel, Leibniz-Center for Medicine and Biosciences, Borstel, Germany.,National Reference Center (NRC) for Mycobacteria, Research Center Borstel, Borstel, Germany.,German Center for Infection Research, Partner Site Hamburg-Borstel-Lübeck, Borstel, Germany
| | - Franz Allerberger
- Austrian Reference Laboratory for Mycobacteria, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria
| | - Walter Haas
- Respiratory Infections Unit, Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| |
Collapse
|
9
|
Sadegh H, Kargarpour Kamakoli M, Farmanfarmaei G, Masoumi M, Abdolrahimi F, Fateh A, Ebrahimzadeh N, Rahimi Jamnani F, Vaziri F, Siadat SD. Pros and cons of direct genotyping on tuberculosis clinical samples. Microb Pathog 2016; 103:135-138. [PMID: 28034830 DOI: 10.1016/j.micpath.2016.12.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/16/2016] [Accepted: 12/16/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Prompt genotyping of Mycobacterium tuberculosis (M. tuberculosis) is crucial for improving molecular epidemiological investigation of tuberculosis (TB). METHODS We performed a retrospective study to evaluate the use of 24 loci MIRU-VNTR (mycobacterial interspersed repetitive unit-variable number of tandem-repeat) directly on 135 clinical samples from 84 TB patients. RESULTS There was a direct correlation between genotyping on clinical samples by MIRU-VNTR and bacterial load (P = 0.001). VNTR loci were amplified successfully for 41.5% of the clinical samples (19-24 loci), 32.6% (13-18 loci), 23.7% (7-12 loci) and 2.2% (1-6 loci). Loci of 2401, 577, 2996 and 154 had the highest power to show the mixed strains infection in clinical samples. CONCLUSIONS Direct MIRU-VNTR is partially successful in complete genotyping of M. tuberculosis strains. On the other hand, detection of polyclonal infection is undoubtedly reliable based on the direct MIRU-VNTR.
Collapse
Affiliation(s)
- Hamidreza Sadegh
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | - Ghazaleh Farmanfarmaei
- Department of Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Morteza Masoumi
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Farid Abdolrahimi
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Nayereh Ebrahimzadeh
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
| | - Fatemeh Rahimi Jamnani
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| | - Farzam Vaziri
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran.
| | - Seyed Davar Siadat
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran; Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| |
Collapse
|
10
|
Methodological and Clinical Aspects of the Molecular Epidemiology of Mycobacterium tuberculosis and Other Mycobacteria. Clin Microbiol Rev 2016; 29:239-90. [PMID: 26912567 DOI: 10.1128/cmr.00055-15] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Molecular typing has revolutionized epidemiological studies of infectious diseases, including those of a mycobacterial etiology. With the advent of fingerprinting techniques, many traditional concepts regarding transmission, infectivity, or pathogenicity of mycobacterial bacilli have been revisited, and their conventional interpretations have been challenged. Since the mid-1990s, when the first typing methods were introduced, a plethora of other modalities have been proposed. So-called molecular epidemiology has become an essential subdiscipline of modern mycobacteriology. It serves as a resource for understanding the key issues in the epidemiology of tuberculosis and other mycobacterial diseases. Among these issues are disclosing sources of infection, quantifying recent transmission, identifying transmission links, discerning reinfection from relapse, tracking the geographic distribution and clonal expansion of specific strains, and exploring the genetic mechanisms underlying specific phenotypic traits, including virulence, organ tropism, transmissibility, or drug resistance. Since genotyping continues to unravel the biology of mycobacteria, it offers enormous promise in the fight against and prevention of the diseases caused by these pathogens. In this review, molecular typing methods for Mycobacterium tuberculosis and nontuberculous mycobacteria elaborated over the last 2 decades are summarized. The relevance of these methods to the epidemiological investigation, diagnosis, evolution, and control of mycobacterial diseases is discussed.
Collapse
|
11
|
Amenuvegbe GK, Francis A, Fred B. Low tuberculosis case detection: a community and health facility based study of contributory factors in the Nkwanta South district of Ghana. BMC Res Notes 2016; 9:330. [PMID: 27357834 PMCID: PMC4928284 DOI: 10.1186/s13104-016-2136-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 06/23/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) continues to pose a major public health problem globally. In Ghana, the national TB case detection rate is 81 %; however, some districts are not able to meet their case detection targets. This study was therefore carried out in the Nkwanta South district to identify possible factors contributing to low TB case detection. METHODS A cross sectional descriptive study involving the review of outpatients records for the year 2012 was conducted. Data on cough for 2 weeks or more duration, age, sex, area of residence and sputum smear examination were extracted. A community-based survey involving household contacts of TB patients and community based volunteers was also carried out. Data collected in the community included knowledge of TB status of relatives, level of socialization with TB patients and signs and symptoms of TB disease. Descriptive statistics including cross-tabulations were used to identify possible factors contributing to low TB case detection. RESULTS A total of 932 patients out of 3987 reported coughing for 2 weeks or more (23.4 %; 932/3987). Out of that, only 24.6 % (230/932) had sputum smear microscopy done, yielding 57 (24.8 %) positive cases. Five out of the 57 positive cases were found not registered for the initiation of treatment leading to a false primary default rate of 8.8 % per year. Eighty-five percent of the contacts were able to mention persistent cough as a sign/symptom of TB with 80.4 % indicating that TB can be cured. Only 10 % of health facilities provided diagnostic services in the district with only 25 % of staff having had training in TB management. CONCLUSION The study identified some factors (weak record review systems, inadequate diagnostic centres, lack of trained persons and some level of stigma at the community level) that could be contributing to low TB case detection in the Nkwanta South district.
Collapse
Affiliation(s)
| | - Anto Francis
- />School of Public Health, University of Ghana, Legon, Ghana
| | - Binka Fred
- />School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| |
Collapse
|
12
|
Chao WC, Wu CL, Liu PY, Shieh CC. Regular Sputum Check-Up for Early Diagnosis of Tuberculosis after Exposure in Healthcare Facilities. PLoS One 2016; 11:e0157054. [PMID: 27258370 PMCID: PMC4892557 DOI: 10.1371/journal.pone.0157054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 05/24/2016] [Indexed: 01/23/2023] Open
Abstract
Background The early diagnosis of patients with TB disease is critical after an outbreak of tuberculosis (TB) infection in healthcare facilities. In this study, we report a catastrophic TB outbreak in a psychiatric healthcare facility and analyze the role of regular sputum check-ups and other diagnostic tools to facilitate an early diagnosis. Methods Every exposed participant received regular sputum check-ups and chest X-rays (CXR) as part of the outbreak management protocol. We retrospectively analyzed data from the contact participants to identify risk factors for eventual TB development and investigated the diagnostic efficacy of regular sputum check-ups. Results Among 133 contact participants, 16 (12.0%) developed TB during the 4-year follow-up period. Low body-mass-index (BMI) (<21) (adjusted hazard ratio (aHR) 3.16, 95% confidence interval (CI) 1.11–8.98) and long duration of contact (>3 months) (aHR 8.70, 95% CI, 1.14–63.34) independently predicted the development of TB. Even though regular sputum check-ups required significant resources, they did facilitate the early identification of new TB cases among the contact participants. Regular sputum check-ups for high-risk patients based on BMI, contact duration and CXR findings may be a practical approach when compared with universal sputum follow-up, with a slightly decreased sensitivity but high positive likelihood ratio (88%, [95% CI, 62–98%] and 5.12, [95%CI, 3.30–7.95], respectively). Conclusion While regular sputum check-ups for all contact participants facilitated the early identification of cases after the outbreak of TB in the healthcare facility, regular sputum check-ups for high-risk patients might be an effective alternative in resource-limited settings.
Collapse
Affiliation(s)
- Wen-Cheng Chao
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan
- Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
| | - Chieh-Liang Wu
- Department of Internal Medicine, Taichung Veteran General Hospital, Taichung, Taiwan
- Center for Quality Management, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Yu Liu
- Department of Internal Medicine, Taichung Veteran General Hospital, Taichung, Taiwan
| | - Chi-Chang Shieh
- Institute of Clinical Medicine, National Cheng Kung University Medical College, Tainan, Taiwan
- Department of Pediatrics, National Cheng Kung University Hospital, Tainan, Taiwan
- * E-mail:
| |
Collapse
|
13
|
Abstract
In long-term care facilities (LTCFs), the elderly are apt to be infected because those with latent tuberculosis infections (LTBIs) are at an increased risk for reactivation and post-primary TB disease. We report an outbreak of TB in staff and residents in a LTCF. An outbreak investigation was conducted after two TB cases were reported from the LTCF. A tuberculin skin test (TST), bacteriological examination and chest radiograph were administered to all facility staff and residents. An outbreak is defined as at least two epidemiologically linked cases that have identical Mycobacterium tuberculosis genotype isolates. This outbreak infected eight residents and one staff member, who were confirmed to have TB in a LTCF between September 2011 and October 2012. Based on the Becker method, the latent and infectious periods were estimated at 223·6 and 55·9 days. Two initial TST-negative resident contacts were diagnosed as TB cases through comprehensive TB screening. Observing elderly people who have a negative TST after TB screening appears to be necessary, given the long latent period for controlling a TB outbreak in a LTCF. It is important to consider providing LTBI treatment for elderly contacts.
Collapse
|
14
|
Oeltmann JE, Click ES, Moonan PK. Using tuberculosis patient characteristics to predict future cases with matching genotype results. Public Health Action 2015; 4:47-52. [PMID: 26423761 DOI: 10.5588/pha.13.0098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 02/01/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING United States. BACKGROUND It is unknown whether tuberculosis (TB) case or patient characteristics can predict the likelihood of future related TB cases. OBJECTIVE To estimate the likelihood for future related cases, i.e., cases with matching TB genotypes within the same county diagnosed within the 2 years following the year of reporting of each included case. DESIGN We considered all TB cases with genotyping results reported in the United States during 2004-2010. Predictive scores were calculated based on patient characteristics by dividing the number of patients who were not the last case in a county-level TB genotype cluster by the total number of patients. RESULTS Overall, there was a 30.8% chance that a future related case would be detected during the 2 years following the report year of any given case. Future related cases were detected in 34.7% of instances following the diagnosis of smear-positive cases, 51.9% of instances following the diagnosis of a homeless patient and 45.2% of instances following the diagnosis of a patient who reported substance abuse. Predictive scores ranged by race (White 13.9%, Native Hawaiian 43.8%) and age group (⩾65 years 13.1%, 0-4 years 43%), and were higher for US-born patients. CONCLUSIONS Behavioral and sociodemographic factors can help predict the likelihood of future related cases and can be used to prioritize contact investigations.
Collapse
Affiliation(s)
- J E Oeltmann
- Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, National Centers for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, Atlanta, Georgia, USA
| | - E S Click
- Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, National Centers for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, Atlanta, Georgia, USA
| | - P K Moonan
- Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, National Centers for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention, Atlanta, Georgia, USA
| |
Collapse
|
15
|
Transmission and Progression to Disease of Mycobacterium tuberculosis Phylogenetic Lineages in The Netherlands. J Clin Microbiol 2015. [PMID: 26224845 DOI: 10.1128/jcm.01370-15] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to determine if mycobacterial lineages affect infection risk, clustering, and disease progression among Mycobacterium tuberculosis cases in The Netherlands. Multivariate negative binomial regression models adjusted for patient-related factors and stratified by patient ethnicity were used to determine the association between phylogenetic lineages and infectivity (mean number of positive contacts around each patient) and clustering (as defined by number of secondary cases within 2 years after diagnosis of an index case sharing the same fingerprint) indices. An estimate of progression to disease by each risk factor was calculated as a bootstrapped risk ratio of the clustering index by the infectivity index. Compared to the Euro-American reference, Mycobacterium africanum showed significantly lower infectivity and clustering indices in the foreign-born population, while Mycobacterium bovis showed significantly lower infectivity and clustering indices in the native population. Significantly lower infectivity was also observed for the East African Indian lineage in the foreign-born population. Smear positivity was a significant risk factor for increased infectivity and increased clustering. Estimates of progression to disease were significantly associated with age, sputum-smear status, and behavioral risk factors, such as alcohol and intravenous drug abuse, but not with phylogenetic lineages. In conclusion, we found evidence of a bacteriological factor influencing indicators of a strain's transmissibility, namely, a decreased ability to infect and a lower clustering index in ancient phylogenetic lineages compared to their modern counterparts. Confirmation of these findings via follow-up studies using tuberculin skin test conversion data should have important implications on M. tuberculosis control efforts.
Collapse
|
16
|
In Vivo IS6110 Profile Changes in a Mycobacterium tuberculosis Strain as Determined by Tracking over 14 Years. J Clin Microbiol 2015; 53:2359-61. [PMID: 25948604 DOI: 10.1128/jcm.00607-15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 04/28/2015] [Indexed: 11/20/2022] Open
Abstract
Transposition and homologous recombination of IS6110 appear in Mycobacterium tuberculosis along in vivo sequential infections. These events were checked in different clones of a successful strain, M. tuberculosis Zaragoza, with the focus on a variant in which integration of a copy of IS6110 in the origin of replication (oriC) region occurred.
Collapse
|
17
|
Mears J, Abubakar I, Cohen T, McHugh TD, Sonnenberg P. Effect of study design and setting on tuberculosis clustering estimates using Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR): a systematic review. BMJ Open 2015; 5:e005636. [PMID: 25609667 PMCID: PMC4305070 DOI: 10.1136/bmjopen-2014-005636] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To systematically review the evidence for the impact of study design and setting on the interpretation of tuberculosis (TB) transmission using clustering derived from Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats (MIRU-VNTR) strain typing. DATA SOURCES MEDLINE, EMBASE, CINHAL, Web of Science and Scopus were searched for articles published before 21st October 2014. REVIEW METHODS Studies in humans that reported the proportion of clustering of TB isolates by MIRU-VNTR were included in the analysis. Univariable meta-regression analyses were conducted to assess the influence of study design and setting on the proportion of clustering. RESULTS The search identified 27 eligible articles reporting clustering between 0% and 63%. The number of MIRU-VNTR loci typed, requiring consent to type patient isolates (as a proxy for sampling fraction), the TB incidence and the maximum cluster size explained 14%, 14%, 27% and 48% of between-study variation, respectively, and had a significant association with the proportion of clustering. CONCLUSIONS Although MIRU-VNTR typing is being adopted worldwide there is a paucity of data on how study design and setting may influence estimates of clustering. We have highlighted study design variables for consideration in the design and interpretation of future studies.
Collapse
Affiliation(s)
- Jessica Mears
- Department of Infection and Population Health, University College London, London, UK
| | - Ibrahim Abubakar
- Department of Infection and Population Health, University College London, London, UK
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
- Clinical Trials Unit, Medical Research Council, London, UK
| | - Theodore Cohen
- Division of Global Health Equity, Brigham and Women's Hospital and Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, USA
| | - Timothy D McHugh
- Department of Infection, Centre for Clinical Microbiology, University College London, London, UK
| | - Pam Sonnenberg
- Department of Infection and Population Health, University College London, London, UK
| |
Collapse
|
18
|
Nebenzahl-Guimaraes H, Borgdorff MW, Murray MB, van Soolingen D. A novel approach - the propensity to propagate (PTP) method for controlling for host factors in studying the transmission of Mycobacterium tuberculosis. PLoS One 2014; 9:e97816. [PMID: 24849817 PMCID: PMC4029888 DOI: 10.1371/journal.pone.0097816] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 04/24/2014] [Indexed: 11/18/2022] Open
Abstract
Rationale Understanding the genetic variations among Mycobacterium tuberculosis (MTB) strains with differential ability to transmit would be a major step forward in preventing transmission. Objectives To describe a method to extend conventional proxy measures of transmissibility by adjusting for patient-related factors, thus strengthening the causal association found with bacterial factors. Methods Clinical, demographic and molecular fingerprinting data were obtained during routine surveillance of verified MTB cases reported in the Netherlands between 1993 and 2011, and the phylogenetic lineages of the isolates were inferred. Odds ratios for host risk factors for clustering were used to obtain a measure of each patient's and cluster's propensity to propagate (CPP). Mean and median cluster sizes across different categories of CPP were compared amongst four different phylogenetic lineages. Results Both mean and median cluster size grew with increasing CPP category. On average, CPP values from Euro-American lineage strains were higher than Beijing and EAI strains. There were no significant differences between the mean and median cluster sizes among the four phylogenetic lineages within each CPP category. Conclusions Our finding that the distribution of CPP scores was unequal across four different phylogenetic lineages supports the notion that host-related factors should be controlled for to attain comparability in measuring the different phylogenetic lineages' ability to propagate. Although Euro-American strains were more likely to be in clusters in an unadjusted analysis, no significant differences among the four lineages persisted after we controlled for host factors.
Collapse
Affiliation(s)
- Hanna Nebenzahl-Guimaraes
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- * E-mail:
| | - Martien W. Borgdorff
- Public Health Service, Amsterdam, Netherlands
- Department of Clinical Epidemiology, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
| | - Megan B. Murray
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, United States of America
| | - Dick van Soolingen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| |
Collapse
|
19
|
Accuracy of prospective space–time surveillance in detecting tuberculosis transmission. Spat Spatiotemporal Epidemiol 2014; 8:47-54. [DOI: 10.1016/j.sste.2014.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 01/11/2014] [Accepted: 01/14/2014] [Indexed: 11/16/2022]
|
20
|
Borgdorff MW, van Soolingen D. The re-emergence of tuberculosis: what have we learnt from molecular epidemiology? Clin Microbiol Infect 2013; 19:889-901. [PMID: 23731470 DOI: 10.1111/1469-0691.12253] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Tuberculosis (TB) has re-emerged over the past two decades: in industrialized countries in association with immigration, and in Africa owing to the human immunodeficiency virus epidemic. Drug-resistant TB is a major threat worldwide. The variable and uncertain impact of TB control necessitates not only better tools (diagnostics, drugs, and vaccines), but also better insights into the natural history and epidemiology of TB. Molecular epidemiological studies over the last two decades have contributed to such insights by answering long-standing questions, such as the proportion of cases attributable to recent transmission, risk factors for recent transmission, the occurrence of multiple Mycobacterium tuberculosis infection, and the proportion of recurrent TB cases attributable to re-infection. M. tuberculosis lineages have been identified and shown to be associated with geographical origin. The Beijing genotype is strongly associated with multidrug resistance, and may have escaped from bacille Calmette-Guérin-induced immunity. DNA fingerprinting has quantified the importance of institutional transmission and laboratory cross-contamination, and has helped to focus contact investigations. Questions to be answered in the near future with whole genome sequencing include identification of chains of transmission within clusters of patients, more precise quantification of mixed infection, and transmission probabilities and rates of progression from infection to disease of various M. tuberculosis lineages, as well as possible variations in vaccine efficacy by lineage. Perhaps most importantly, dynamics in the population structure of M. tuberculosis in response to control measures in high-prevalence areas should be better understood.
Collapse
Affiliation(s)
- M W Borgdorff
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam and Centre for Infection and Immunity Amsterdam (CINIMA), Amsterdam, The Netherlands
| | | |
Collapse
|
21
|
Zhang D, An J, Wang J, Hu C, Wang Z, Zhang R, Wang Y, Pang Y. Molecular typing and drug susceptibility of Mycobacterium tuberculosis isolates from Chongqing Municipality, China. INFECTION GENETICS AND EVOLUTION 2012. [PMID: 23183314 DOI: 10.1016/j.meegid.2012.10.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
China's tuberculosis (TB) burden is second only to that of India worldwide. In Chongqing, the largest municipality in southwestern China, although the prevalence of both TB and drug-resistant TB is higher than in other municipalities, the molecular characteristics and drug susceptibility phenotypes are poorly known. In this study, 297 Mycobacterium tuberculosis isolates from Chongqing were genotyped with spacer oligonucleotide typing (spoligotyping) and 28-locus MIRU-VNTR (24-locus MIRU-VNTR scheme and 4 other loci). Spoligotyping results were compared with drug-resistant profiles. Patients who showed clustering by both spoligotyping and 28-locus MIRU-VNTR were interviewed to investigate their detailed contact history. Our data demonstrated that the Beijing genotype was the most prevalent genotype, and ST1 was the most predominant lineage in Chongqing. The Beijing genotype was significantly associated with ethambutol resistance and multidrug-resistant phenotypes. A combination of the 10 most polymorphic loci permitted to achieve higher discriminatory power than 24-VNTR. In addition, a presumed transmission pathway was observed in a cluster of patients with the same MIRU-VNTR profile. The 10-VNTR locus set is suitable for genotyping of Mycobacterium tuberculosis in Chongqing.
Collapse
Affiliation(s)
- Dan Zhang
- Yongchuan Hospital, Chongqing Medical University, Chongqing, China
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Althomsons SP, Kammerer JS, Shang N, Navin TR. Using routinely reported tuberculosis genotyping and surveillance data to predict tuberculosis outbreaks. PLoS One 2012; 7:e48754. [PMID: 23144956 PMCID: PMC3492443 DOI: 10.1371/journal.pone.0048754] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 10/05/2012] [Indexed: 11/19/2022] Open
Abstract
We combined routinely reported tuberculosis (TB) patient characteristics with genotyping data and measures of geospatial concentration to predict which small clusters (i.e., consisting of only 3 TB patients) in the United States were most likely to become outbreaks of at least 6 TB cases. Of 146 clusters analyzed, 16 (11.0%) grew into outbreaks. Clusters most likely to become outbreaks were those in which at least 1 of the first 3 patients reported homelessness or excess alcohol or illicit drug use or was incarcerated at the time of TB diagnosis and in which the cluster grew rapidly (i.e., the third case was diagnosed within 5.3 months of the first case). Of 17 clusters with these characteristics and therefore considered high risk, 9 (53%) became outbreaks. This retrospective cohort analysis of clusters in the United States suggests that routinely reported data may identify small clusters that are likely to become outbreaks and which are therefore candidates for intensified contact investigations.
Collapse
Affiliation(s)
- Sandy P Althomsons
- Centers for Disease Control and Prevention, Division of Tuberculosis Elimination, Atlanta, Georgia, United States of America.
| | | | | | | |
Collapse
|
23
|
Beijing sublineages of Mycobacterium tuberculosis differ in pathogenicity in the guinea pig. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2012; 19:1227-37. [PMID: 22718126 DOI: 10.1128/cvi.00250-12] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Beijing family of Mycobacterium tuberculosis strains is part of lineage 2 (also known as the East Asian lineage). In clinical studies, we have observed that isolates from the sublineage RD207 of lineage 2 were more readily transmitted among humans. To investigate the basis for this difference, we tested representative strains with the characteristic Beijing spoligotype from four of the five sublineages of lineage 2 in the guinea pig model and subjected these strains to comparative whole-genome sequencing. The results of these studies showed that all of the clinical strains were capable of growing and causing lung pathology in guinea pigs after low-dose aerosol exposure. Differences between the abilities of the four sublineages to grow in the lungs of these animals were not overt, but members of RD207 were significantly more pathogenic, resulting in severe lung damage. The RD207 strains also induced much higher levels of markers associated with regulatory T cells and showed a significant loss of activated T cells in the lungs over the course of the infections. Whole-genome sequencing of the strains revealed mutations specific for RD207 which may explain this difference. Based on these data, we hypothesize that the sublineages of M. tuberculosis are associated with distinct pathological and clinical phenotypes and that these differences influence the transmissibility of particular M. tuberculosis strains in human populations.
Collapse
|
24
|
Borgdorff MW, van den Hof S, Kalisvaart N, Kremer K, van Soolingen D. Influence of sampling on clustering and associations with risk factors in the molecular epidemiology of tuberculosis. Am J Epidemiol 2011; 174:243-51. [PMID: 21606233 DOI: 10.1093/aje/kwr061] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Molecular epidemiologic studies may use genotypic clustering of isolates as an indicator of recent transmission. It has been shown that missing cases lead to underestimating clustering, and modelling studies suggested that they may also lead to underestimating odds ratios for clustering. Using a national, comprehensive database from the Netherlands covering 15 years between 1993 and 2007 and including over 12,000 patients and their isolates, the authors determined the effects of sampling at random, in time, and by geographic area. As expected, sampling reduced the observed clustering percentages. However, sampling did not reduce the observed odds ratios for clustering. The main explanations for this discrepancy with model outcomes were that a substantial proportion of clustered cases were found in large clusters and that risk factors for clustering tended to be-among clustered cases-also risk factors for large clusters. The authors conclude that, in settings where risk factors for clustering may be interpreted as risk factors for recent transmission, these risk factors are also associated with larger cluster sizes. As a result, odds ratios would show limited sampling bias.
Collapse
Affiliation(s)
- Martien W Borgdorff
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, University of Amsterdam, the Netherlands.
| | | | | | | | | |
Collapse
|
25
|
Evans JT, Serafino Wani RL, Anderson L, Gibson AL, Smith EG, Wood A, Olowokure B, Abubakar I, Mann JS, Gardiner S, Jones H, Sonnenberg P, Hawkey PM. A geographically-restricted but prevalent Mycobacterium tuberculosis strain identified in the West Midlands Region of the UK between 1995 and 2008. PLoS One 2011; 6:e17930. [PMID: 21464965 PMCID: PMC3064665 DOI: 10.1371/journal.pone.0017930] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Accepted: 02/20/2011] [Indexed: 11/21/2022] Open
Abstract
Background We describe the identification of, and risk factors for, the single most prevalent Mycobacterium tuberculosis strain in the West Midlands region of the UK. Methodology/Principal Findings Prospective 15-locus MIRU-VNTR genotyping of all M. tuberculosis isolates in the West Midlands between 2004 and 2008 was undertaken. Two retrospective epidemiological investigations were also undertaken using univariable and multivariable logistic regression analysis. The first study of all TB patients in the West Midlands between 2004 and 2008 identified a single prevalent strain in each of the study years (total 155/3,056 (5%) isolates). This prevalent MIRU-VNTR profile (32333 2432515314 434443183) remained clustered after typing with an additional 9-loci MIRU-VNTR and spoligotyping. The majority of these patients (122/155, 79%) resided in three major cities located within a 40 km radius. From the apparent geographical restriction, we have named this the “Mercian” strain. A multivariate analysis of all TB patients in the West Midlands identified that infection with a Mercian strain was significantly associated with being UK-born (OR = 9.03, 95%CI = 4.56–17.87, p<0.01), Black Caribbean (OR = 5.68, 95%CI = 2.96–10.91, p<0.01) resident in Wolverhampton (OR = 9.29, 95%CI = 5.69–15.19, p<0.01) and negatively associated with age >65 years old (OR = 0.25, 95%CI = 0.09–0.67, p<0.01). A second more detailed investigation analyzed a cohort of 82 patients resident in Wolverhampton between 2003 and 2006. A significant association with being born in the UK remained after a multivariate analysis (OR = 9.68, 95%CI = 2.00–46.78, p<0.01) and excess alcohol intake and cannabis use (OR = 6.26, 95%CI = 1.45–27.02, p = .01) were observed as social risk factors for infection. Conclusions/Significance The continued consistent presence of the Mercian strain suggests ongoing community transmission. Whilst significant associations have been found, there may be other common risk factors yet to be identified. Future investigations should focus on targeting the relevant risk groups and elucidating the biological factors that mediate continued transmission of this strain.
Collapse
Affiliation(s)
- Jason T Evans
- Health Protection Agency West Midlands Laboratory, Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham, United Kingdom.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Verhagen LM, van den Hof S, van Deutekom H, Hermans PWM, Kremer K, Borgdorff MW, van Soolingen D. Mycobacterial factors relevant for transmission of tuberculosis. J Infect Dis 2011; 203:1249-55. [PMID: 21378376 DOI: 10.1093/infdis/jir013] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) transmission is associated with patient-related risk factors. However, DNA fingerprint analysis has provided anecdotal evidence suggesting a role for bacteriological factors. METHODS To examine the importance of the bacteriological component in TB transmission, we investigated the number of tuberculin skin test-positive (TST induration, ≥ 10 mm) contacts and secondary cases observed in contact investigations around TB cases in relation to the size of the genotype cluster the patient belonged to at the time of diagnosis. We also compared the number of TST-positive contacts and secondary cases of patients with drug-resistant and drug-susceptible TB. RESULTS Larger clusters were independently associated with an increased number of positive contacts. The mean number of positive contacts ranged from 3.8 for clusters of 2 cases, to 4.7 for clusters of 3-10 cases, to 6.0 for cases in clusters of >10 cases (mean increase in number of positive contacts for every extra case in the cluster, 0.21; 95% confidence interval, 0.09-0.26). The mean number of positive contacts was significantly lower among index cases with isoniazid-monoresistant TB (1.6) than among index cases with pan-susceptible TB (4.6; relative number, 0.45; 95% confidence interval, 0.22-0.92). CONCLUSION These results suggest that spread of tuberculosis also depends on bacteriological factors.
Collapse
Affiliation(s)
- Lilly M Verhagen
- Tuberculosis Reference Laboratory, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven.
| | | | | | | | | | | | | |
Collapse
|
27
|
Talarico S, Ijaz K, Zhang X, Mukasa LN, Zhang L, Marrs CF, Cave MD, Bates JH, Yang Z. Identification of factors for tuberculosis transmission via an integrated multidisciplinary approach. Tuberculosis (Edinb) 2011; 91:244-9. [PMID: 21367661 DOI: 10.1016/j.tube.2011.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 01/07/2011] [Accepted: 01/26/2011] [Indexed: 11/16/2022]
Abstract
It was reported previously that the major fraction of the recent decrease of tuberculosis incident cases in Arkansas had been due to a decrease in the reactivated infections. Preventing transmission of Mycobacterium tuberculosis is the key to a continued decline in tuberculosis cases. In this study, we integrated epidemiological data analysis and comparative genomics to identify host and microbial factors important to tuberculosis transmission. A significantly higher proportion of cases in large clusters (containing >10 cases) were non-Hispanic black, homeless, less than 65 years old, male sex, smear-positive sputum, excessive use of alcohol, and HIV sero-positive, compared to cases in small clusters (containing 2-5 cases) diagnosed within one year. However, being non-Hispanic black and homeless within the past year were the only two host characteristics that were identified as independent risk factors for being in large clusters. This finding suggests that social behavioral factors have a more important role in transmission of tuberculosis than does the infectiousness of the source. Comparing the genomic content of one of the large cluster strains to that of a non-clustered strain from the same community identified 25 genes that differed between the two strains, potentially contributing to the observed differences in transmission.
Collapse
Affiliation(s)
- Sarah Talarico
- Department of Epidemiology, School of Public Health, University of Michigan, M5124 SPH II, 1415 Washington Heights, Ann Arbor, MI 48109-2029, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Alonso Rodríguez N, Martínez Lirola M, Chaves F, lñigo J, Herranz M, Ritacco V, Bouza E, García de Viedma D. Differences in the robustness of clusters involving the Mycobacterium tuberculosis strains most frequently isolated from immigrant cases in Madrid. Clin Microbiol Infect 2010; 16:1544-54. [DOI: 10.1111/j.1469-0691.2010.03161.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
29
|
Schürch AC, Kremer K, Daviena O, Kiers A, Boeree MJ, Siezen RJ, van Soolingen D. High-resolution typing by integration of genome sequencing data in a large tuberculosis cluster. J Clin Microbiol 2010; 48:3403-6. [PMID: 20592143 PMCID: PMC2937716 DOI: 10.1128/jcm.00370-10] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Revised: 04/19/2010] [Accepted: 06/22/2010] [Indexed: 01/20/2023] Open
Abstract
To investigate whether genome sequencing yields more useful markers than those currently used to study the epidemiology of tuberculosis, it was applied to three Mycobacterium tuberculosis isolates of the Harlingen outbreak. Our findings suggest that single nucleotide polymorphisms can be used to identify transmission chains in restriction fragment length polymorphism clusters.
Collapse
Affiliation(s)
- Anita C. Schürch
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, Netherlands, Radboud University Nijmegen Medical Centre/NCMLS, Centre for Molecular and Biomolecular Informatics, P.O. Box 9101, 6500 HB Nijmegen, Netherlands, Department of Tuberculosis Control GGD Fryslân, P.O. Box 601, 8901 BK Leeuwarden, Netherlands, University Centre for Chronic Diseases, Department of Pulmonary Disease, Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands
| | - Kristin Kremer
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, Netherlands, Radboud University Nijmegen Medical Centre/NCMLS, Centre for Molecular and Biomolecular Informatics, P.O. Box 9101, 6500 HB Nijmegen, Netherlands, Department of Tuberculosis Control GGD Fryslân, P.O. Box 601, 8901 BK Leeuwarden, Netherlands, University Centre for Chronic Diseases, Department of Pulmonary Disease, Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands
| | - Olaf Daviena
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, Netherlands, Radboud University Nijmegen Medical Centre/NCMLS, Centre for Molecular and Biomolecular Informatics, P.O. Box 9101, 6500 HB Nijmegen, Netherlands, Department of Tuberculosis Control GGD Fryslân, P.O. Box 601, 8901 BK Leeuwarden, Netherlands, University Centre for Chronic Diseases, Department of Pulmonary Disease, Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands
| | - Albert Kiers
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, Netherlands, Radboud University Nijmegen Medical Centre/NCMLS, Centre for Molecular and Biomolecular Informatics, P.O. Box 9101, 6500 HB Nijmegen, Netherlands, Department of Tuberculosis Control GGD Fryslân, P.O. Box 601, 8901 BK Leeuwarden, Netherlands, University Centre for Chronic Diseases, Department of Pulmonary Disease, Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands
| | - Martin J. Boeree
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, Netherlands, Radboud University Nijmegen Medical Centre/NCMLS, Centre for Molecular and Biomolecular Informatics, P.O. Box 9101, 6500 HB Nijmegen, Netherlands, Department of Tuberculosis Control GGD Fryslân, P.O. Box 601, 8901 BK Leeuwarden, Netherlands, University Centre for Chronic Diseases, Department of Pulmonary Disease, Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands
| | - Roland J. Siezen
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, Netherlands, Radboud University Nijmegen Medical Centre/NCMLS, Centre for Molecular and Biomolecular Informatics, P.O. Box 9101, 6500 HB Nijmegen, Netherlands, Department of Tuberculosis Control GGD Fryslân, P.O. Box 601, 8901 BK Leeuwarden, Netherlands, University Centre for Chronic Diseases, Department of Pulmonary Disease, Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands
| | - Dick van Soolingen
- Tuberculosis Reference Laboratory, National Institute for Public Health and the Environment (RIVM), Centre for Infectious Disease Control, P.O. Box 1, 3720 BA Bilthoven, Netherlands, Radboud University Nijmegen Medical Centre/NCMLS, Centre for Molecular and Biomolecular Informatics, P.O. Box 9101, 6500 HB Nijmegen, Netherlands, Department of Tuberculosis Control GGD Fryslân, P.O. Box 601, 8901 BK Leeuwarden, Netherlands, University Centre for Chronic Diseases, Department of Pulmonary Disease, Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, Netherlands
| |
Collapse
|
30
|
Schürch AC, Kremer K, Kiers A, Daviena O, Boeree MJ, Siezen RJ, Smith NH, van Soolingen D. The tempo and mode of molecular evolution of Mycobacterium tuberculosis at patient-to-patient scale. INFECTION GENETICS AND EVOLUTION 2010; 10:108-14. [DOI: 10.1016/j.meegid.2009.10.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 10/06/2009] [Accepted: 10/07/2009] [Indexed: 11/24/2022]
|
31
|
Prospective universal application of mycobacterial interspersed repetitive-unit-variable-number tandem-repeat genotyping to characterize Mycobacterium tuberculosis isolates for fast identification of clustered and orphan cases. J Clin Microbiol 2009; 47:2026-32. [PMID: 19458183 DOI: 10.1128/jcm.02308-08] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The use of molecular tools for genotyping Mycobacterium tuberculosis isolates in epidemiological surveys in order to identify clustered and orphan strains requires faster response times than those offered by the reference method, IS6110 restriction fragment length polymorphism (RFLP) genotyping. A method based on PCR, the mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) genotyping technique, is an option for fast fingerprinting of M. tuberculosis, although precise evaluations of correlation between MIRU-VNTR and RFLP findings in population-based studies in different contexts are required before the methods are switched. In this study, we evaluated MIRU-VNTR genotyping (with a set of 15 loci [MIRU-15]) in parallel to RFLP genotyping in a 39-month universal population-based study in a challenging setting with a high proportion of immigrants. For 81.9% (281/343) of the M. tuberculosis isolates, both RFLP and MIRU-VNTR types were obtained. The percentages of clustered cases were 39.9% (112/281) and 43.1% (121/281) for RFLP and MIRU-15 analyses, and the numbers of clusters identified were 42 and 45, respectively. For 85.4% of the cases, the RFLP and MIRU-15 results were concordant, identifying the same cases as clustered and orphan (kappa, 0.7). However, for the remaining 14.6% of the cases, discrepancies were observed: 16 of the cases clustered by RFLP analysis were identified as orphan by MIRU-15 analysis, and 25 cases identified as orphan by RFLP analysis were clustered by MIRU-15 analysis. 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.
Collapse
|
32
|
Affiliation(s)
- Wing Wai Yew
- Tuberculosis and Chest Unit, Grantham Hospital, Hong Kong, China.
| | | |
Collapse
|
33
|
Tostmann A, Kik SV, Kalisvaart NA, Sebek MM, Verver S, Boeree MJ, van Soolingen D. Tuberculosis Transmission by Patients with Smear‐Negative Pulmonary Tuberculosis in a Large Cohort in The Netherlands. Clin Infect Dis 2008; 47:1135-42. [PMID: 18823268 DOI: 10.1086/591974] [Citation(s) in RCA: 201] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Alma Tostmann
- Department of Pulmonary Diseases, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
34
|
DeRiemer K, de Jong BC. Catch Them While You Can! Am J Respir Crit Care Med 2008; 178:5-6. [DOI: 10.1164/rccm.200804-589ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Bouke C. de Jong
- New York University
New York, New York
and
MRC Laboratories
Banjul, The Gambia
| |
Collapse
|