Molecular Epidemiology of Tuberculosis in a Sentinel Surveillance Population

• Main Authors: Barbara A. Ellis, Jack T. Crawford, Christopher R. Braden, Scott J. N. McNabb, Marisa Moore, Steve Kammerer
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2002-11-01
• Series: Emerging Infectious Diseases
• Subjects: Sentinel surveillance; restriction fragment-length polymorphism; insertion sequence elements; risk factors; Mycobacterium tuberculosis; United States
• Online Access: https://wwwnc.cdc.gov/eid/article/8/11/02-0403_article

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 11,923 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.