BACKGROUND: DNA fingerprinting of Mycobacterium tuberculosis isolates offers better opportunities to study links between tuberculosis (TB) cases and can highlight relevant issues in urban TB control in low-endemic countries. METHODS: A medium-sized molecular cluster of TB cases with identical DNA fingerprints was used for the development of a visual presentation of epidemiologic links between cases. RESULTS: Of 32 cases, 17 (53%) were linked to the index case, and 11 (34%) to a secondary case. The remaining four (13%) could not be linked and were classified as possibly caused by the index patient. Of the 21 cases related to the index case, TB developed within one year of the index diagnosis in 11 patients (52%), within one to two years in four patients (19%), and within two to five years in six patients (29%). CONCLUSION: Cluster analysis underscored several issues for TB control in an urban setting, such as the recognition of the outbreak, the importance of reinfections, the impact of delayed diagnosis, the contribution of pub-related transmissions and its value for decision-making to extend contact investigations. Visualising cases in a cluster diagram was particularly useful in finding transmission locations and the similarities and links between patients.
BACKGROUND: DNA fingerprinting of Mycobacterium tuberculosis isolates offers better opportunities to study links between tuberculosis (TB) cases and can highlight relevant issues in urban TB control in low-endemic countries. METHODS: A medium-sized molecular cluster of TB cases with identical DNA fingerprints was used for the development of a visual presentation of epidemiologic links between cases. RESULTS: Of 32 cases, 17 (53%) were linked to the index case, and 11 (34%) to a secondary case. The remaining four (13%) could not be linked and were classified as possibly caused by the index patient. Of the 21 cases related to the index case, TB developed within one year of the index diagnosis in 11 patients (52%), within one to two years in four patients (19%), and within two to five years in six patients (29%). CONCLUSION: Cluster analysis underscored several issues for TB control in an urban setting, such as the recognition of the outbreak, the importance of reinfections, the impact of delayed diagnosis, the contribution of pub-related transmissions and its value for decision-making to extend contact investigations. Visualising cases in a cluster diagram was particularly useful in finding transmission locations and the similarities and links between patients.
Authors: J A Caminero; M J Pena; M I Campos-Herrero; J C Rodríguez; O Afonso; C Martin; J M Pavón; M J Torres; M Burgos; P Cabrera; P M Small; D A Enarson Journal: Am J Respir Crit Care Med Date: 2001-03 Impact factor: 21.405
Authors: J R Glynn; J Bauer; A S de Boer; M W Borgdorff; P E Fine; P Godfrey-Faussett; E Vynnycky Journal: Int J Tuberc Lung Dis Date: 1999-12 Impact factor: 2.373
Authors: T Lillebaek; A B Andersen ; J Bauer; A Dirksen; S Glismann; P de Haas; A Kok-Jensen Journal: J Clin Microbiol Date: 2001-03 Impact factor: 5.948
Authors: Elvin Geng; Barry Kreiswirth; Cynthia Driver; Jiehui Li; Joseph Burzynski; Phyllis DellaLatta; Angel LaPaz; Neil W Schluger Journal: N Engl J Med Date: 2002-05-09 Impact factor: 91.245
Authors: A Bandera; A Gori; L Catozzi; A Degli Esposti; G Marchetti; C Molteni; G Ferrario; L Codecasa; V Penati; A Matteelli; F Franzetti Journal: J Clin Microbiol Date: 2001-06 Impact factor: 5.948
Authors: Inge Roof; Rana Jajou; Miranda Kamst; Arnout Mulder; Albert de Neeling; Rianne van Hunen; Wim van der Hoek; Dick van Soolingen Journal: J Clin Microbiol Date: 2018-10-25 Impact factor: 5.948
Authors: Esther L Hamblion; Arnaud Le Menach; Laura F Anderson; Maeve K Lalor; Tim Brown; Ibrahim Abubakar; Charlotte Anderson; Helen Maguire; Sarah R Anderson Journal: Thorax Date: 2016-08 Impact factor: 9.139