Long-Term Molecular Analysis of Tuberculosis Strains in Alabama, a State Characterized by a Largely Indigenous, Low-Risk Population
| Autor: | William H. Benjamin, Nancy E. Dunlap, Michael E. Kimerling, Nancy B. Keenan, Kerry H. Lok, Mirjam-Colette Kempf |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male Microbiology (medical) Time Factors Tuberculosis Population Gene Dosage Alcohol abuse Disease Biology Indigenous Risk Factors medicine Cluster Analysis Humans Typing education Tuberculosis Pulmonary Aged Molecular Epidemiology education.field_of_study Transmission (medicine) Mycobacteriology and Aerobic Actinomycetes Mycobacterium tuberculosis Middle Aged medicine.disease Bacterial Typing Techniques Immunology Alabama DNA Transposable Elements Female Restriction fragment length polymorphism Polymorphism Restriction Fragment Length Demography |
| Zdroj: | Journal of Clinical Microbiology. 43:870-878 |
| ISSN: | 1098-660X 0095-1137 |
| DOI: | 10.1128/jcm.43.2.870-878.2005 |
| Popis: | With a tuberculosis case detection rate of 5.9 per 100,000 population in 2001, Alabama ranked twelfth highest in the United States. However, cases among foreign-born and human immunodeficiency virus-infected individuals remain low in Alabama. To understand the endemic statewide disease pattern, tuberculosis strains were studied for clustering in a long-term population-based study from January 1994 to May 2000. IS6 110 restriction fragment length polymorphism analysis was performed for 1,834 strains. Spoligotyping was used as a secondary typing method for the 37% of isolates displaying a restriction fragment length polymorphism pattern with 6110 copies. A total of 721 (41%) patients provided isolates that composed 114 clusters, each containing isolates from 2 to 136 patients, suggesting that recent transmission accounted for 35% of tuberculosis cases. Demographic, behavioral, and clinical characteristics of patients with clustered versus nonclustered isolates stratified by low-copy-number strains (6110 copies) versus high-copy-number strains (≥6 IS 6110 copies) were evaluated. Younger age, black race, a history of alcohol abuse, and homelessness were predictors of clustering of low-copy-number, strains and younger age, urban residency, alcohol abuse, homelessness, noninjection drug use, and a history of incarceration and/or cavitary disease were predictors of clustering of high-copy-number strains. By identifying local characteristics of tuberculosis clustering through molecular fingerprinting, control programs can distribute their limited resources to impact the transmission of tuberculosis in high-risk populations and evaluate strain distribution across geographical areas. |
| Databáze: | OpenAIRE |
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