Molecular epidemiology of tuberculosis in a sentinel surveillance population

• Published in: Emerging infectious diseases Vol. 8; no. 11; pp. 1197 - 1209
• Main Authors: Ellis, Barbara A, Crawford, Jack T, Braden, Christopher R, McNabb, Scott J N, Moore, Marisa, Kammerer, Steve
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01-11-2002; Centers for Disease Control and Prevention
• Subjects: Adolescent; Adult; Aged; Analysis; Antitubercular Agents - pharmacology; Antitubercular Agents - therapeutic use; Child; Child, Preschool; Cluster Analysis; Continental Population Groups; Dispatch; DNA, Bacterial - genetics; Drug Resistance, Multiple, Bacterial; Epidemiology; Female; Genotype; Health surveys; Humans; Infant; insertion sequence elements; Longitudinal Studies; Male; Middle Aged; Molecular Epidemiology; Mycobacterium tuberculosis; Mycobacterium tuberculosis - classification; Mycobacterium tuberculosis - drug effects; Mycobacterium tuberculosis - genetics; Mycobacterium tuberculosis - isolation & purification; Polymorphism, Restriction Fragment Length; restriction fragment-length polymorphism; Risk Factors; Risk factors (Health); Sentinel Surveillance; Surveys; Time Factors; Tuberculosis; Tuberculosis - drug therapy; Tuberculosis - epidemiology; Tuberculosis - microbiology; United States; United States
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid0811.020403

We conducted a population-based study to assess demographic and risk-factor correlates for the most frequently occurring Mycobacterium tuberculosis genotypes from tuberculosis (TB) patients. The study included all incident, culture-positive TB patients from seven sentinel surveillance sites in the United States from 1996 to 2000. M. tuberculosis isolates were genotyped by IS6110-based restriction fragment length polymorphism and spoligotyping. Genotyping was available for 90% of 11923 TB patients. Overall, 48% of cases had isolates that matched those from another patient, including 64% of U.S.-born and 35% of foreign-born patients. By logistic regression analysis, risk factors for clustering of genotypes were being male, U.S.-born, black, homeless, and infected with HIV; having pulmonary disease with cavitations on chest radiograph and a sputum smear with acid-fast bacilli; and excessive drug or alcohol use. Molecular characterization of TB isolates permitted risk correlates for clusters and specific genotypes to be described and provided information regarding cluster dynamics over time.