title: Factors associated with recently transmitted Mycobacterium tuberculosis strain MS0006 in Hinds County, Mississippi.
abstract: OBJECTIVE
  The objective of this study was to investigate risk factors associated with tuberculosis (TB) transmission that was caused by Mycobacterium tuberculosis strain MS0006 from 2004 to 2009 in Hinds County, Mississippi.
  
  
  METHODS
  DNA fingerprinting using spoligotyping, mycobacterial interspersed repetitive unit, and IS6110-based restriction fragment length polymorphism of culture-confirmed cases of TB was performed. Clinical and demographic factors associated with strain MS0006 were analyzed by univariate and multivariate analysis.
  
  
  RESULTS
  Of the 144 cases of TB diagnosed during the study period, 117 were culture positive with fingerprints available. There were 48 different strains, of which 6 clustered strains were distributed among 74 patients. The MS0006 strain accounted for 46.2% of all culture-confirmed cases. Risk factors for having the MS0006 strain in a univariate analysis included homelessness, HIV co-infection, sputum smear negativity, tuberculin skin test negativity, and noninjectable drug use. Multivariate analysis identified homelessness (odds ratio 7.88, 95% confidence interval 2.90-21.35) and African American race (odds ratio 5.80, 95% confidence interval 1.37-24.55) as independent predictors of having TB caused by the MS0006 strain of M. tuberculosis.
  
  
  CONCLUSIONS
  Our findings suggest that a majority of recently transmitted TB in the studied county was caused by the MS0006 strain. African American race and homelessness were significant risk factors for inclusion in the cluster. Molecular epidemiology techniques continue to provide in-depth analysis of disease transmission and play a vital role in effective contact tracing and interruption of ongoing transmission.
authors.affiliation: Division of Infectious Diseases, Warren Alpert Medical School, Brown University/Miriam Hospital, Providence, Rhode Island, USA. btemple@umc.edu
authors.forename: Brian
authors.initials: B
authors.lastname: Temple
authors.forename: Awewura
authors.initials: A
authors.lastname: Kwara
authors.forename: Imran
authors.initials: I
authors.lastname: Sunesara
authors.forename: Leandro
authors.initials: L
authors.lastname: Mena
authors.forename: Thomas
authors.initials: T
authors.lastname: Dobbs
authors.forename: Harold
authors.initials: H
authors.lastname: Henderson
authors.forename: Mike
authors.initials: M
authors.lastname: Holcomb
authors.forename: Risa
authors.initials: R
authors.lastname: Webb
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D016172:DNA Fingerprinting; D005260:Female; D015658:HIV Infections / Q000150:complications; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008922:Mississippi / Q000453:epidemiology; D015999:Multivariate Analysis; D009169:Mycobacterium tuberculosis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000209:etiology / Q000382:microbiology / Q000635:transmission*; D055815:Young Adult
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