title: Molecular epidemiology of Mycobacterium tuberculosis complex in Brussels, 2010-2013.
abstract: The tuberculosis (TB) incidence rate in Brussels-Capital Region is 3-fold higher than in Belgium as a whole. Eight years after the realization of initial prospective population-based molecular epidemiology investigations in this Region, a similar study over the period 2010-2013 was conducted. TB strains isolated from 945 patients were submitted to genotyping by standardized 24-locus-MIRU-VNTR typing and spoligotyping. The phylogenetic analysis showed that the LAM (16.7%) and Haarlem (15.7%) branches are the two most prevalent TB lineages circulating in Brussels. Analysis of the MDR subgroup showed an association with Beijing strains (39.9%) and patients native of Eastern Europe (40.7%). Genotyping detected 113 clusters involving 321 patients, giving a recent transmission index of 22.9%. Molecular-guided epidemiological investigations and routine surveillance activities revealed family transmission or social contact for patients distributed over 34 clusters. Most of the patients were foreign-born (75.7%). However, cluster analysis revealed only limited trans-national transmission. Comparison with the previous study shows a stable epidemiological situation except for the mean age difference between Belgian-born and foreign-born patients which has disappeared. This study confirms that molecular epidemiology has become an important determinant for TB control programs. However, sufficient financial means need to be available to perform all required epidemiological investigations.
authors.affiliation: Bacterial Diseases Service, Operational Direction Communicable and Infectious Diseases, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors.forename: Christelle
authors.initials: C
authors.lastname: Vluggen
authors.affiliation: Bacterial Diseases Service, Operational Direction Communicable and Infectious Diseases, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors.forename: Karine
authors.initials: K
authors.lastname: Soetaert
authors.affiliation: Belgian Lung and Tuberculosis Association, Brussels, Belgium.
authors.forename: Guido
authors.initials: G
authors.lastname: Groenen
authors.affiliation: Belgian Lung and Tuberculosis Association, Brussels, Belgium.
authors.forename: Maryse
authors.initials: M
authors.lastname: Wanlin
authors.affiliation: Belgian Lung and Tuberculosis Association, Brussels, Belgium.
authors.forename: Martine
authors.initials: M
authors.lastname: Spitaels
authors.affiliation: Belgian Lung and Tuberculosis Association, Brussels, Belgium.
authors.forename: Wouter
authors.initials: W
authors.lastname: Arrazola de Oñate
authors.affiliation: Bacterial Diseases Service, Operational Direction Communicable and Infectious Diseases, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors.forename: Maryse
authors.initials: M
authors.lastname: Fauville-Dufaux
authors.affiliation: Research Unit of Epidemiology and Risk Analysis applied to Veterinary Sciences (UREAR-ULg), Fundamental and Applied Research for Animal and Health (FARAH) Centre, Liège, Belgium.
authors.forename: Claude
authors.initials: C
authors.lastname: Saegerman
authors.affiliation: Bacterial Diseases Service, Operational Direction Communicable and Infectious Diseases, Scientific Institute of Public Health (WIV-ISP), Brussels, Belgium.
authors.forename: Vanessa
authors.identifier: http://orcid.org/0000-0001-5218-927X
authors.initials: V
authors.lastname: Mathys
mesh_terms: D000293:Adolescent; D000328:Adult; D015373:Bacterial Typing Techniques / Q000379:methods; D001530:Belgium / Q000453:epidemiology; D002648:Child; D016000:Cluster Analysis; D016358:Contact Tracing; D024901:Drug Resistance, Multiple, Bacterial; D054242:Emigrants and Immigrants; D005192:Family Health; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D010802:Phylogeny; D011159:Population Surveillance; D014376:Tuberculosis / Q000191:economics / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission; D014504:Urban Health; D055815:Young Adult