title: Molecular epidemiology of tuberculosis in the Czech Republic, 2004: analysis of M. tuberculosis complex isolates originating from the city of prague, south Moravia and the Moravian-Silesian region.
abstract: OBJECTIVE
  To compare M. tuberculosis complex genotypes from representative regions of the Czech Republic in order to estimate changes in strain prevalence and in the extent of imported drug-resistant tuberculosis.
  
  
  METHODS
  Primary M. tuberculosis complex isolates (n=155) and follow-up isolates (n=15) from 155 patients from the first half of 2004 (98 from Prague, 37 from South Moravia and 35 from the Moravian-Silesian region) were genotyped by IS6110-RFLP, spoligotyping, and partly by VNTR-genotyping.
  
  
  RESULTS
  Based on IS6110-RFLP, 110 of 155 (71%) primary isolates were unique. Forty-five isolates (29%) were found in 15 clusters comprising two to six patients and all but one cluster were also discriminated by MIRU-VNTR-genotyping. Four clusters comprised patients from different regions, and six were ongoing for several years. An indication of MDR-strain transmission was found in one instance. All four Beijing-type isolates with any resistance were associated with immigration from Eastern Europe.
  
  
  CONCLUSIONS
  The molecular epidemiological data of this period-prevalence, population based study and its comparison to earlier investigations point to a low extent of clustering between M. tuberculosis complex isolates in representative regions of the Czech Republic. Few clusters extending geographically and/or over several years were identified, providing a means for an in-depth analysis of risk factors of transmission. Beijing genotype isolates were shown to increase in prevalence to reach 6.5%. Drug resistant isolates of this genotype were associated with immigration of from Eastern Europe, although direct transmission of a resistant isolate was probable only in one of eleven cases.
authors.affiliation: Dept. of Hygiene, Microbiology and Social Medicine, Division of Hygiene and Medical Microbiology, Innsbruck Medical University, Innsbruck, Austria. wolfgang.prodinger@i-med.ac.at
authors.forename: Wolfgang M
authors.initials: WM
authors.lastname: Prodinger
authors.forename: Vladimír
authors.initials: V
authors.lastname: Polanecký
authors.forename: Bohumila
authors.initials: B
authors.lastname: Kozáková
authors.forename: Maria
authors.initials: M
authors.lastname: Müllerová
authors.forename: Lev
authors.initials: L
authors.lastname: Mezenský
authors.forename: Jarmila
authors.initials: J
authors.lastname: Kaustová
authors.forename: Carolin
authors.initials: C
authors.lastname: Lechleitner
authors.forename: Milan
authors.initials: M
authors.lastname: Kubín
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000302:isolation & purification; D015995:Prevalence; D014376:Tuberculosis / Q000453:epidemiology* / Q000235:genetics