title: Molecular epidemiology of multidrug-resistant tuberculosis, New York City, 1995-1997.
abstract: From January 1, 1995, to December 31, 1997, we reviewed records of all New York City patients who had multidrug-resistant tuberculosis (MDRTB); we performed insertion sequence (IS) 6110-based DNA genotyping on the isolates. Secondary genotyping was performed for low IS6110 copy band strains. Patients with identical DNA pattern strains were considered clustered. From 1995 through 1997, MDRTB was diagnosed in 241 patients; 217 (90%) had no prior treatment history, and 166 (68.9%) were born in the United States or Puerto Rico. Compared with non-MDRTB patients, MDRTB patients were more likely to be born in the United States, have HIV infection, and work in health care. Genotyping results were available for 234 patients; 153 (65.4%) were clustered, 126 (82.3%) of them in eight clusters of >or=4 patients. Epidemiologic links were identified for 30 (12.8%) patients; most had been exposed to patients diagnosed before the study period. These strains were likely transmitted in the early 1990 s when MDRTB outbreaks and tuberculosis transmission were widespread in New York.
authors.affiliation: New York City Department of Health, New York, New York 10013, USA. smunsiff@health.nyc.gov
authors.forename: Sonal S
authors.initials: SS
authors.lastname: Munsiff
authors.forename: Trina
authors.initials: T
authors.lastname: Bassoff
authors.forename: Beth
authors.initials: B
authors.lastname: Nivin
authors.forename: Jiehui
authors.initials: J
authors.lastname: Li
authors.forename: Anu
authors.initials: A
authors.lastname: Sharma
authors.forename: Pablo
authors.initials: P
authors.lastname: Bifani
authors.forename: Barun
authors.initials: B
authors.lastname: Mathema
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Driscoll
authors.forename: Barry N
authors.initials: BN
authors.lastname: Kreiswirth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D009519:New York City / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D000995:Antitubercular Agents