title: Mycobacterium tuberculosis population structure and molecular epidemiological analysis in Sucre municipality, Miranda state, Venezuela.
abstract: Sucre municipality is a large, densely populated marginal area in the eastern part of Caracas, Venezuela that consistently has more cases of tuberculosis than other municipalities in the country. To identify the neighborhoods in the municipality with the highest prevalence of tuberculosis, and determine whether the Mycobacterium tuberculosis strain distribution in this municipality is different from that previously found in the western part of Caracas and the rest of Venezuela, we collected data on all tuberculosis cases in the municipality diagnosed in 2005-6. We performed two separate molecular epidemiological studies, spoligotyping 44 strains in a first study, and spoligotyping 131 strains, followed by MIRU-VNTR 15 on 21 clustered isolates in the second. With spoligotyping, the most common patterns were Shared International Type SIT17 (21%); SIT42 (15%); SIT93 (11%); SIT20 (7%); SIT53 (6%), a distribution similar to other parts of Venezuela, except that SIT42 and SIT20 were more common. MIRU-VNTR 15 showed that six of seven SIT17 strains examined belonged to a large cluster previously found circulating in Venezuela, but all of the SIT42 strains were related to a cluster centered in the neighborhoods of Unión and Maca, with a MIRU-VNTR pattern not previously seen in Venezuela. It appears that a large percentage of the tuberculosis in the Sucre municipality is caused by the active transmission of two strain families centered within distinct neighborhoods, one reflecting communication with the rest of the country, and the other suggesting the insular, isolated nature of some sectors.
authors.affiliation: Instituto Venezolano de Investigaciones Cientícas España, Altos de Pipe, Venezuela.
authors.forename: Margareth A
authors.initials: MA
authors.lastname: Patiño
authors.forename: Edgar
authors.initials: E
authors.lastname: Abadía
authors.lastname: Solalba Gómez
authors.forename: Mailis
authors.initials: M
authors.lastname: Maes
authors.forename: Mariana
authors.initials: M
authors.lastname: Muñoz
authors.forename: Daniela
authors.initials: D
authors.lastname: Gómez
authors.forename: Patricia
authors.initials: P
authors.lastname: Guzmán
authors.forename: María Victoria
authors.initials: MV
authors.lastname: Méndez
authors.forename: Carmen
authors.initials: C
authors.lastname: Ramirez
authors.forename: España
authors.initials: E
authors.lastname: Mercedes
authors.forename: Jacobus
authors.initials: J
authors.lastname: de Waard
authors.forename: Howard
authors.initials: H
authors.lastname: Takiff
mesh_terms: D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D064112:Clustered Regularly Interspaced Short Palindromic Repeats / Q000235:genetics; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D010865:Pilot Projects; D016133:Polymerase Chain Reaction / Q000379:methods; D012111:Residence Characteristics; D012189:Retrospective Studies; D012689:Sequence Homology, Nucleic Acid; D013045:Species Specificity; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology*; D014505:Urban Population; D014687:Venezuela / Q000453:epidemiology