[Molecular strain typing contribution to epidemiology of tuberculosis in Limousin (1998 to 2006)].

Autor: Bezanahary H; Service de médecine interne, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France., Baclet MC, Sola C, Gazaille V, Turlure P, Weinbreck P, Denis F, Martin C
Jazyk: francouzština
Zdroj: Medecine et maladies infectieuses [Med Mal Infect] 2008 Jun; Vol. 38 (6), pp. 309-17. Date of Electronic Publication: 2008 Apr 18.
DOI: 10.1016/j.medmal.2008.02.008
Abstrakt: Objectives: We conducted a molecular epidemiology of Mycobacterium tuberculosis in Limousin, a French area with a low incidence of tuberculosis (4.8/100,000 inhabitants in 2005) to define the molecular diversity and the pattern of transmission.
Design: Two hundred and fifty-nine strains were isolated (each strain corresponds to one patient) from 1998 to 2006. Both spoligotyping and MIRU15 were chosen for our study because of their discriminatory power.
Results: Only 165 medical records were available: 99M/66F, mean age 56.4 years (14-94), 32.7% foreign-born patients, 16.9% homeless or living in shelters, 21.8% of immunocompromised patients (three HIV positive), 14.5% of alcohol addicts. Pulmonary manifestations were predominant (81.8%) with 45.1% of positive smears. Two strains among the 259 presented a multidrug resistance. Spoligotyping identified 136/259 spoligotypes (110 unique, 26 clusters composed of two to 36 isolates); within these 26 clusters, ST53 (n=36) and ST50 (n=19) were the most frequent. Three major families were observed as follow: T1 (30%), Haarlem (30%) and LAM (20%). MIRU15 identified 28/36 isolates in the ST53 group and 14/19 in the ST50 group. Eleven clusters (32 strains) with identical ST-MIRU15 were obtained with a proved case of recent transmission. Alcohol dependence, immunosuppression and pulmonary infections seem to be involved in transmission factors.
Conclusion: M. tuberculosis strains isolated in Limousin are characterized by their high genetic diversity. The rate of recent transmission (8.1%) is low and therefore a reactivation process is predominant in this area.
Databáze: MEDLINE
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