Transmission of Tuberculosis in New York City -- An Analysis by DNA Fingerprinting and Conventional Epidemiologic Methods

Alland, David; Kalkut, Gary; Moss, Andrew R.; McAdam, Ruth A.; Hahn, Judith A.; Bosworth, William; Drucker, Ernest; Bloom, Barry R.

doi:10.1056/nejm199406163302403

Cited by 711 publications

(439 citation statements)

References 16 publications

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“…However, this did not reach significance at the P l 0n05 level and should be treated with caution, especially in view of the use of multiple significance testing in this study. Increased clustering among HIVinfected tuberculosis patients has been found in some studies [7,8] but not in others [6,9]. High levels of clustering in HIV infected patients are likely to reflect problems with nosocomial transmission of disease [10].…”

Section: Discussionmentioning

confidence: 95%

“…The high degree of heterogeneity means indistinguishable strains are likely to represent chains of recent transmission [5]. This property has been exploited in a number of studies of tuberculosis transmission in different settings [6][7][8][9][10]. However, the time required to culture sufficient M. tuberculosis for DNA extraction delays the public health benefits of molecular epidemiological techniques.…”

Section: Introductionmentioning

confidence: 99%

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The molecular epidemiology of tuberculosis in inner London

Hayward

Goss²,

Drobniewski³

et al. 2002

Epidemiol. Infect.

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SUMMARYThe study used DNA fingerprint typing (spoligotyping and Heminested-Inverse-PCR) of Mycobacterium tuberculosis from all culture-confirmed inner London patients over a 12-month period to describe transmission. The methodology was evaluated by comparison with standard IS6110 typing and by examining its ability to identify known household clusters of cases. Isolates sharing indistinguishable typing patterns using both techniques were defined as clustered. Clusters were investigated to identify epidemiological links. The methodology showed good discriminatory power and identified known household clusters of cases. Of 694 cultureconfirmed cases, 563 (81 %) were typed. Eleven (2 %) were due to laboratory crosscontamination and were excluded. Of the remaining 552 isolates 148 (27 %) were clustered. Multivariate analysis indicated that clustering was more common in those with pulmonary smear positive disease (P 0n02) ; those born in the United Kingdom (P 0n0003) and in patients living in south London (P l 0n02). There was also a trend towards clustering being more common in those not known to have HIV infection (P l 0n051). The results suggest that in inner London, recent local transmission makes an important contribution to notification rates.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

The molecular epidemiology of tuberculosis in inner London

Hayward

Goss²,

Drobniewski³

et al. 2002

Epidemiol. Infect.

View full text Add to dashboard Cite

show abstract

“…During the 1980's, it was believed in the industrialized countries that the eradication of tuberculosis (TB) was imminent, and research in this field became scarce. Only in the early 1990's, when outbreaks of multidrugresistant tuberculosis (MDR-TB) in HIV-positive subjects in the USA and Europe were published, worldwide attention was given to the problem (3) . MDR-TB is defined as a case with a bacillus resistant to at least RFP + INH (4) .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for acquired multidrug-resistant tuberculosis

E¹,

Mota

Santos³

et al. 2003

J. Pneumologia

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“…Population based studies in different developed countries demonstrated that tuberculosis resulting from recent transmission was higher than the estimated 10% predicted by traditional epidemiological studies. In these countries, 25% to 45% of new cases of tuberculosis were demonstrated to be the result of recent transmission (8,62,63). A common denominator of risk factors was found to be associated with recent transmission: lower socioeconomic status and HIV coinfection.…”

Section: Transmission and Tuberculosis Controlmentioning

confidence: 99%

Epidemiología molecular de la tuberculosis: métodos y aplicaciones

2004

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The resurgence of tuberculosis around the world has renewed interest in understanding the epidemiology and pathogenesis of this disease. A revolutionary advance in the field of tuberculosis research has been the development of molecular techniques that permit identification and tracking of individual strains of Mycobacterium tuberculosis. With these techniques, molecular epidemiology has been established as a new discipline that adds another dimension to the classical epidemiology of tuberculosis and has increased our understanding of the transmission dynamics of M. tuberculosis. The increased epidemiological knowledge has led to discovery of inadequacies in tuberculosis control programs; this information has helped garner resources for program improvement and has highlighted the need for the continuous surveillance of tuberculosis. Additional genetic methods are being developed based on the knowledge of the genome sequence of M. tuberculosis. These simpler and less costly genotyping techniques promise to expand the application of molecular epidemiology to developing nations (where 90% of the disease burden occurs) in support of national tuberculosis programs. Furthermore, these tools permit ever more effective probes into the dynamics of transmission, the population structure, evolution and pathogenesis of M. tuberculosis.Key words: tuberculosis, Mycobacterium tuberculosis/pathogenicity/drug effects, molecular epidemiology, genotype, DNA fingerprinting/methods, restriction fragment length polymorphins. Epidemiología molecular de la tuberculosis: métodos y aplicacionesLa reemergencia de la tuberculosis en el mundo ha despertado el interés en el entendimiento de la epidemiología y patogénesis de esta enfermedad. Un revolucionario avance en este campo de investigación ha sido el desarrollo de técnicas moleculares que permiten identificar y establecer la huella particular de cada cepa de M. tuberculosis. Con el uso de estas técnicas, y el establecimiento de la epidemilogia molecular como nueva disciplina se adicionó otra dimensión a la epidemiologia clásica de la tuberculosis y ha incrementado el conocimiento de la dinámica de la transmisión de M. tuberculosis dentro de una población. En el proceso han sido identificados problemas en los programas de control, lo cual ha ayudado a obtener recursos para su mejoramineto e implementación. Aún más, se ha resaltado la necesidad de continuar vigilando esta enfermedad. Otras metodologías genotípicas han sido desarrolladas a partir del conocimiento de la secuencia del genoma de M. tuberculosis. Estas metodologías genotípicas de fácil implementación y bajo costo se deben aplicar en países en vía de desarrollo, donde existe el 90% de la enfermedad, como apoyo a los programas de control de la tuberculosis. Estas herramientas permitirán conocer la dinámica de transmisión de la tuberculosis, la estructura de la población, la evolución y patogénesis de M. tuberculosis.Palabras clave: tuberculosis, Mycobacterium tuberculosis/patogenicidad/efecto de drogas, epidemiología molecular,...

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Transmission of Tuberculosis in New York City -- An Analysis by DNA Fingerprinting and Conventional Epidemiologic Methods

Cited by 711 publications

References 16 publications

The molecular epidemiology of tuberculosis in inner London

The molecular epidemiology of tuberculosis in inner London

Risk factors for acquired multidrug-resistant tuberculosis

Epidemiología molecular de la tuberculosis: métodos y aplicaciones

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