Molecular epidemiology of tuberculosis in Cuba outside of Havana, July 1994-June 1995: utility of spoligotyping versus IS6110 restriction fragment length polymorphism.
METHODS
Molecular typing has become an important tool for examining the extent of active transmission of tuberculosis.


OBJECTIVE
To examine transmission of tuberculosis in Cuba using IS6110 restriction fragment length polymorphism (RFLP) typing and to evaluate the utility of spoligotyping.


METHODS
One hundred and sixty Mycobacterium tuberculosis strains isolated over a one year period in Cuba were subjected to RFLP and spoligotyping.


RESULTS
Forty-eight percent of the isolates were found in 19 clusters of strains with identical RFLP patterns. In general, cluster sizes were limited, except for two large institutional outbreaks. Age was strongly inversely correlated to clustering. Most streptomycin-resistant isolates were found in clusters. Fifteen spoligotype clusters comprised 78% of the isolates. Significantly different IS6110 RFLP types subdivided 11 spoligotype clusters, whereas none of the IS6110 clusters were subdivided by spoligotyping.


CONCLUSIONS
Considering the short study period, 48% clustering is high, indicating that recent transmission plays an important role in Cuba. Although resistance is still a minor problem, transmission of streptomycin-resistant strains occurs. The high polymorphism observed with IS6110 RFLP indicates that this marker is useful for future molecular epidemiological studies in Cuba. Spoligotyping appeared less suitable for population-based studies.
Diaz
R
R
National Reference Laboratory on Tuberculosis and Mycobacteria, Institute Pedro Kouri, Havana, Cuba.
Kremer
K
K
de Haas
P E
PE
Gomez
R I
RI
Marrero
A
A
Valdivia
J A
JA
van Embden
J D
JD
van Soolingen
D
D
D016000:Cluster Analysis; D003462:Cuba / Q000453:epidemiology; D016172:DNA Fingerprinting; D004352:Drug Resistance, Microbial; D006801:Humans; D017720:Molecular Epidemiology / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D012150:Polymorphism, Restriction Fragment Length; D013307:Streptomycin / Q000494:pharmacology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*
D013307:Streptomycin