title: Diverse Genotypes of Yersinia pestis Caused Plague in Madagascar in 2007.
abstract: BACKGROUND
  Yersinia pestis is the causative agent of human plague and is endemic in various African, Asian and American countries. In Madagascar, the disease represents a significant public health problem with hundreds of human cases a year. Unfortunately, poor infrastructure makes outbreak investigations challenging.
  
  
  RESULTS
  DNA was extracted directly from 93 clinical samples from patients with a clinical diagnosis of plague in Madagascar in 2007. The extracted DNAs were then genotyped using three molecular genotyping methods, including, single nucleotide polymorphism (SNP) typing, multi-locus variable-number tandem repeat analysis (MLVA), and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) analysis. These methods provided increasing resolution, respectively. The results of these analyses revealed that, in 2007, ten molecular groups, two newly described here and eight previously identified, were responsible for causing human plague in geographically distinct areas of Madagascar.
  
  
  CONCLUSIONS
  Plague in Madagascar is caused by numerous distinct types of Y. pestis. Genotyping method choice should be based upon the discriminatory power needed, expense, and available data for any desired comparisons. We conclude that genotyping should be a standard tool used in epidemiological investigations of plague outbreaks.
authors.affiliation: Central Institute of the Bundeswehr Medical Service, Munich, Germany.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Riehm
authors.affiliation: Bundeswehr Institute of Microbiology & German Center for Infectious Diseases, Munich, Germany.
authors.forename: Michaela
authors.initials: M
authors.lastname: Projahn
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: Amy J
authors.initials: AJ
authors.lastname: Vogler
authors.affiliation: Institut Pasteur de Madagascar, Antananarivo, Madagascar.
authors.forename: Minoaerisoa
authors.initials: M
authors.lastname: Rajerison
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Andersen
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: Carina M
authors.initials: CM
authors.lastname: Hall
authors.affiliation: Central Institute of the Bundeswehr Medical Service, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Zimmermann
authors.affiliation: Institut Pasteur de Madagascar, Antananarivo, Madagascar.
authors.forename: Rahelinirina
authors.initials: R
authors.lastname: Soanandrasana
authors.affiliation: Institut Pasteur de Madagascar, Antananarivo, Madagascar.
authors.forename: Voahangy
authors.initials: V
authors.lastname: Andrianaivoarimanana
authors.affiliation: Institute for Infectious Medicine and Zoonoses, Munich, Germany.
authors.forename: Reinhard K
authors.initials: RK
authors.lastname: Straubinger
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Nottingham
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America; Translational Genomics Research Institute North, Flagstaff, Arizona, United States of America.
authors.forename: Paul
authors.initials: P
authors.lastname: Keim
authors.affiliation: Center for Microbial Genetics and Genomics, Northern Arizona University, Flagstaff, Arizona, United States of America.
authors.forename: David M
authors.initials: DM
authors.lastname: Wagner
authors.affiliation: Bundeswehr Institute of Microbiology & German Center for Infectious Diseases, Munich, Germany.
authors.forename: Holger C
authors.initials: HC
authors.lastname: Scholz
mesh_terms: D064112:Clustered Regularly Interspaced Short Palindromic Repeats; D005838:Genotype; D006801:Humans; D008270:Madagascar / Q000453:epidemiology; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D010930:Plague / Q000453:epidemiology* / Q000382:microbiology*; D020641:Polymorphism, Single Nucleotide; D015010:Yersinia pestis / Q000145:classification / Q000235:genetics*