title: Strain-specific differences in two large Mycobacterium tuberculosis genotype clusters in isolates collected from homeless patients in New York City from 2001 to 2004.
abstract: We studied two large Mycobacterium tuberculosis genotype clusters associated with recent outbreaks in homeless persons to determine factors associated with these tuberculosis (TB) strains. Isolates from all culture-positive TB cases diagnosed from 1 January 2001 to 31 December 2004 were genotyped. Patients whose isolates had identical restriction fragment length polymorphism patterns and spoligotypes were considered clustered. Health department records were reviewed and reinterviews attempted for clustered cases. Patients with the Cs30 and BEs75 strains were compared to other genotypically clustered cases and to each other. The two largest genotype clusters among homeless persons were the Cs30 strain (n = 105) and the BEs75 strain (n = 47). Fifty-one (49%) patients with the Cs30 strain and 28 (60%) with the BEs75 strain were homeless. Compared to patients with the BEs75 strain, patients with the Cs30 strain were less likely to be respiratory acid-fast bacillus smear positive (51% versus 72%). Furthermore, patients with the BEs75 strain were more likely to be HIV infected (74% versus 42%), which suggests that most patients with this strain advanced to disease after recent infection. Cases in clusters of strains that have been circulating in the community over a long time period, such as the Cs30 strain, require additional investigation to determine whether clustering is a result of recent transmission or reactivation of remote infection.
authors.affiliation: New York City Department of Health and Mental Hygiene, 225 Broadway, 22nd Floor, New York, NY 10007, USA. mmacarai@health.nyc.gov
authors.forename: Michelle
authors.initials: M
authors.lastname: Macaraig
authors.forename: Tracy
authors.initials: T
authors.lastname: Agerton
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Driver
authors.forename: Sonal S
authors.initials: SS
authors.lastname: Munsiff
authors.forename: Jalaa'
authors.initials: J
authors.lastname: Abdelwahab
authors.forename: Julie
authors.initials: J
authors.lastname: Park
authors.forename: Barry
authors.initials: B
authors.lastname: Kreiswirth
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Driscoll
authors.forename: Benyang
authors.initials: B
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications; D006703:Ill-Housed Persons; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D009519:New York City / Q000453:epidemiology; D012150:Polymorphism, Restriction Fragment Length; D013183:Sputum / Q000382:microbiology; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology*
chemical_list: D004269:DNA, Bacterial