title: Molecular epidemiology of tuberculosis in a sentinel surveillance population.
abstract: We conducted a population-based study to assess demographic and risk-factor correlates for the most frequently occurring Mycobacterium tuberculosis genotypes from tuberculosis (TB) patients. The study included all incident, culture-positive TB patients from seven sentinel surveillance sites in the United States from 1996 to 2000. M. tuberculosis isolates were genotyped by IS6110-based restriction fragment length polymorphism and spoligotyping. Genotyping was available for 90% of 11923 TB patients. Overall, 48% of cases had isolates that matched those from another patient, including 64% of U.S.-born and 35% of foreign-born patients. By logistic regression analysis, risk factors for clustering of genotypes were being male, U.S.-born, black, homeless, and infected with HIV; having pulmonary disease with cavitations on chest radiograph and a sputum smear with acid-fast bacilli; and excessive drug or alcohol use. Molecular characterization of TB isolates permitted risk correlates for clusters and specific genotypes to be described and provided information regarding cluster dynamics over time.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. bae7@cdc.gov
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Ellis
authors.forename: Jack T
authors.initials: JT
authors.lastname: Crawford
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Braden
authors.forename: Scott J N
authors.initials: SJ
authors.lastname: McNabb
authors.forename: Marisa
authors.initials: M
authors.lastname: Moore
authors.forename: Steve
authors.initials: S
authors.lastname: Kammerer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D012150:Polymorphism, Restriction Fragment Length; D044469:Racial Groups; D012307:Risk Factors; D018571:Sentinel Surveillance; D013997:Time Factors; D014376:Tuberculosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D014481:United States
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial