title: Molecular epidemiology of tuberculosis in Finland, 2008-2011.
abstract: In industrialized countries the majority of tuberculosis (TB) cases are linked to immigration. In Finland, most cases are still Finnish born but the number of foreign born cases is steadily increasing. In this 4-year population based study, the TB situation in Finland was characterized by a genotypic analysis of Mycobacterium tuberculosis isolates. A total of 1048 M. tuberculosis isolates (representing 99.4% of all culture positive cases) were analyzed by spoligotyping and MIRU. Spoligotype lineages belonging to the Euro-American family were predominant among the Finnish isolates, particularly T (n=346, 33.0%) and Haarlem (n=237, 22.6%) strains. The lineage signature was unknown for 130 (12.4%) isolates. Out of the 17 multi-drug resistant TB strains, 10 (58.8%) belonged to the Beijing lineage. In total, 23 new SIT designations were given and 51 orphan strains were found, of which 58 patterns were unique to Finland. Phylogeographical TB mapping as compared to neighboring countries showed that the population structure in Finland most closely resembled that observed in Sweden. By combining spoligotyping and MIRU results, 98 clusters comprising 355 isolates (33.9%) were found. Only 10 clusters contained both Finnish and foreign born cases. In conclusion, a large proportion of the M. tuberculosis isolates were from Finnish born elderly patients. Moreover, many previously unidentified spoligotype profiles and isolates belonging to unknown lineages were encountered.
authors.affiliation: European Public Health Microbiology Training Programme, (EUPHEM), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden ; Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Pieter Willem
authors.initials: PW
authors.lastname: Smit
authors.affiliation: Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Marjo
authors.initials: M
authors.lastname: Haanperä
authors.affiliation: Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Pirre
authors.initials: P
authors.lastname: Rantala
authors.affiliation: WHO Supranational TB Reference Laboratory, Tuberculosis & Mycobacteria Unit, Institut Pasteur de la Guadeloupe, Abymes, France.
authors.forename: David
authors.initials: D
authors.lastname: Couvin
authors.affiliation: Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Outi
authors.initials: O
authors.lastname: Lyytikäinen
authors.affiliation: WHO Supranational TB Reference Laboratory, Tuberculosis & Mycobacteria Unit, Institut Pasteur de la Guadeloupe, Abymes, France.
authors.forename: Nalin
authors.initials: N
authors.lastname: Rastogi
authors.affiliation: Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Petri
authors.initials: P
authors.lastname: Ruutu
authors.affiliation: Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Hanna
authors.initials: H
authors.lastname: Soini
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology / Q000379:methods; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D058974:Phylogeography; D012189:Retrospective Studies; D014376:Tuberculosis / Q000453:epidemiology / Q000235:genetics