| Literature DB >> 29748309 |
Maeve K Lalor1,2, Nicola Casali3,4, Timothy M Walker5, Laura F Anderson1, Jennifer A Davidson1, Natasha Ratna1, Cathy Mullarkey6, Mike Gent7, Kirsty Foster8, Tim Brown3, John Magee9,10, Anne Barrett9, Derrick W Crook5,11, Francis Drobniewski3,4, H Lucy Thomas1, Ibrahim Abubakar1,2.
Abstract
We used whole-genome sequencing (WGS) to delineate transmission networks and investigate the benefits of WGS during cluster investigation.We included clustered cases of multidrug-resistant (MDR) tuberculosis (TB)/extensively drug-resistant (XDR) TB linked by mycobacterial interspersed repetitive unit variable tandem repeat (MIRU-VNTR) strain typing or epidemiological information in the national cluster B1006, notified between 2007 and 2013 in the UK. We excluded from further investigation cases whose isolates differed by greater than 12 single nucleotide polymorphisms (SNPs). Data relating to patients' social networks were collected.27 cases were investigated and 22 had WGS, eight of which (36%) were excluded as their isolates differed by more than 12 SNPs to other cases. 18 cases were ruled into the transmission network based on genomic and epidemiological information. Evidence of transmission was inconclusive in seven out of 18 cases (39%) in the transmission network following WGS and epidemiological investigation.This investigation of a drug-resistant TB cluster illustrates the opportunities and limitations of WGS in understanding transmission in a setting with a high proportion of migrant cases. The use of WGS should be combined with classical epidemiological methods. However, not every cluster will be solvable, regardless of the quality of genomic data.Entities:
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Year: 2018 PMID： 29748309 DOI： 10.1183/13993003.02313-2017
Source DB: PubMed Journal: Eur Respir J ISSN： 0903-1936 Impact factor: 16.671