Use of Rapid Genomic Deletion Typing To Monitor a Tuberculosis Outbreak within an Urban Homeless Population
Open Access
- 1 November 2005
- journal article
- research article
- Published by American Society for Microbiology in Journal of Clinical Microbiology
- Vol. 43 (11), 5550-5554
- https://doi.org/10.1128/jcm.43.11.5550-5554.2005
Abstract
Beginning in mid-2002, a large tuberculosis outbreak occurred among homeless persons in King County, Washington. In order to further monitor the outbreak following its peak in 2003, Mycobacterium tuberculosis isolates from all new King County tuberculosis (TB) patients in 2004 and the first half of 2005 ( n = 220) were genotyped by using a rapid comparative genomics-based (genomic deletion-typing) approach, with confirmation by mycobacterial interspersed repetitive units and repetitive-sequence-based PCR (rep-PCR). Results were compared to retrospective genotypic data from 1995 to 2003. The outbreak strain SBRI9, which was not seen among King County homeless persons prior to 2002, accounted for 16 out of 30 TB cases (53%) within this population in 2002. This trend continued with 27 out of 35 cases (77%) caused by the outbreak strain in 2003, 11 out of 13 cases (85%) caused by the outbreak strain in 2004, and 4 out of 10 cases (40%) caused by the outbreak strain in the first 5 months of 2005. Thus, the outbreak strain remained well established within this homeless population throughout the study period. At least four SBRI9 cases were in people who had previously been infected by other strains. The novel PCR-based strain-typing approach used in this investigation proved to be cost-effective and very rapid. In most cases, it was possible to analyze DNA extracted directly from primary isolation ( Mycobacterium growth indicator tube) cultures submitted by clinical laboratories, a feature that markedly reduced the delay between diagnosis and strain typing results. This rapid turnaround facilitated public health efforts to prevent new outbreaks involving this strain.Keywords
This publication has 21 references indexed in Scilit:
- Stable association between strains of Mycobacterium tuberculosis and their human host populationsProceedings of the National Academy of Sciences of the United States of America, 2004
- Functional and evolutionary genomics of Mycobacterium tuberculosis : Insights from genomic deletions in 100 strainsProceedings of the National Academy of Sciences of the United States of America, 2004
- Expanded Geographical Distribution of the N Family of Mycobacterium tuberculosis Strains within the United StatesJournal of Clinical Microbiology, 2004
- Molecular Epidemiology of TuberculosisNew England Journal of Medicine, 2003
- Snapshot of Moving and Expanding Clones of Mycobacterium tuberculosis and Their Global Distribution Assessed by Spoligotyping in an International StudyJournal of Clinical Microbiology, 2003
- Differences in Rate and Variability of Intracellular Growth of a Panel ofMycobacterium tuberculosisClinical Isolates within a Human Monocyte ModelInfection and Immunity, 2002
- Global dissemination of the Mycobacterium tuberculosis W-Beijing family strainsTrends in Microbiology, 2002
- Molecular epidemiology of tuberculosis: achievements and challenges to current knowledge.2002
- Automated High-Throughput Genotyping for Study of Global Epidemiology of Mycobacterium tuberculosis Based on Mycobacterial Interspersed Repetitive UnitsJournal of Clinical Microbiology, 2001
- Virulence of a Mycobacterium tuberculosis clinical isolate in mice is determined by failure to induce Th1 type immunity and is associated with induction of IFN-α/βProceedings of the National Academy of Sciences of the United States of America, 2001