title: [Molecular epidemiology of tuberculosis in Almeria (Spain). Factors associated with recent transmission].
abstract: BACKGROUND
  Molecular epidemiology is used in tuberculosis (TB) to identify clusters in which the cases are assumed to belong to the same recent transmission chain. An endogenous reactivation of latent TB is considered when the Mycobacterium tuberculosis isolates have a unique genotype.
  
  
  OBJECTIVE
  To describe factors associated with recent transmission of TB in Almeria, from 2003-2007.
  
  
  METHODS
  We conducted an observational prospective study that included patients with Mycobacterium tuberculosis positive culture. The strains were genotyped by Restriction Fragment Length Polymorphism and spoligotyping. Adjusted odds ratio and 95% confidence intervals were calculated to study factors associated with cluster groups, using a multivariate logistic regression model.
  
  
  RESULTS
  We analysed 427 isolates, of which 71% were from males and 56.2% of them belonged to foreign residents. Furthermore, 44% were classified as a cluster. The resistance to isoniazid was 8.4%. The factors associated with clusters were age, principally the group under 10 years (adjusted OR=12.75; 95% CI, 2.52-64.58) and the group aged between 50-59 years (adjusted OR=13.85; 95% CI, 3.04-63.17), and born in Spain (adjusted OR=2.17; 95% CI, 1.41-3.36).
  
  
  CONCLUSIONS
  In Almeria, native population, children under 10 years old and patients aged between 50-59 years have more probability to belong to the same recent transmission chain. The molecular epidemiology can be used to find out which population groups need more control and this information must be used in tuberculosis prevention programs.
authors.affiliation: Empresa Pública Hospital de Poniente, El Ejido, Almería, España. mariaangeles.lucerna@ephpo.es
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Lucerna
authors.forename: Rafael
authors.initials: R
authors.lastname: Rodríguez-Contreras
authors.forename: Pilar
authors.initials: P
authors.lastname: Barroso
authors.forename: Miguel José
authors.initials: MJ
authors.lastname: Martínez
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Sánchez-Benítez
authors.forename: Dario
authors.initials: D
authors.lastname: García de Viedma
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000208:ethnology; D000368:Aged; D000569:Americas / Q000208:ethnology; D000995:Antitubercular Agents / Q000494:pharmacology; D001208:Asia / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005060:Europe / Q000208:ethnology; D005260:Female; D005838:Genotype; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial