Standard Genotyping Overestimates Transmission of Mycobacterium tuberculosis among Immigrants in a Low-Incidence Country.

Details

Serval ID
serval:BIB_A3A0FD5BC136
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Standard Genotyping Overestimates Transmission of Mycobacterium tuberculosis among Immigrants in a Low-Incidence Country.
Journal
Journal of clinical microbiology
Author(s)
Stucki D., Ballif M., Egger M., Furrer H., Altpeter E., Battegay M., Droz S., Bruderer T., Coscolla M., Borrell S., Zürcher K., Janssens J.P., Calmy A., Mazza Stalder J., Jaton K., Rieder H.L., Pfyffer G.E., Siegrist H.H., Hoffmann M., Fehr J., Dolina M., Frei R., Schrenzel J., Böttger E.C., Gagneux S., Fenner L.
ISSN
1098-660X (Electronic)
ISSN-L
0095-1137
Publication state
Published
Issued date
07/2016
Peer-reviewed
Oui
Volume
54
Number
7
Pages
1862-1870
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Immigrants from regions with a high incidence of tuberculosis (TB) are a risk group for TB in low-incidence countries such as Switzerland. In a previous analysis of a nationwide collection of 520 Mycobacterium tuberculosis isolates from 2000 to 2008, we identified 35 clusters comprising 90 patients based on standard genotyping (24-locus mycobacterial interspersed repetitive-unit-variable-number tandem-repeat [MIRU-VNTR] typing and spoligotyping). Here, we used whole-genome sequencing (WGS) to revisit these transmission clusters. Genome-based transmission clusters were defined as isolate pairs separated by ≤12 single nucleotide polymorphisms (SNPs). WGS confirmed 17/35 (49%) MIRU-VNTR typing clusters; the other 18 clusters contained pairs separated by >12 SNPs. Most transmission clusters (3/4) of Swiss-born patients were confirmed by WGS, as opposed to 25% (4/16) of the clusters involving only foreign-born patients. The overall clustering proportion was 17% (90 patients; 95% confidence interval [CI], 14 to 21%) by standard genotyping but only 8% (43 patients; 95% CI, 6 to 11%) by WGS. The clustering proportion was 17% (67/401; 95% CI, 13 to 21%) by standard genotyping and 7% (26/401; 95% CI, 4 to 9%) by WGS among foreign-born patients and 19% (23/119; 95% CI, 13 to 28%) and 14% (17/119; 95% CI, 9 to 22%), respectively, among Swiss-born patients. Using weighted logistic regression, we found weak evidence of an association between birth origin and transmission (adjusted odds ratio of 2.2 and 95% CI of 0.9 to 5.5 comparing Swiss-born patients to others). In conclusion, standard genotyping overestimated recent TB transmission in Switzerland compared to WGS, particularly among immigrants from regions with a high TB incidence, where genetically closely related strains often predominate. We recommend the use of WGS to identify transmission clusters in settings with a low incidence of TB.

Keywords
Adolescent, Adult, Cluster Analysis, Disease Transmission, Infectious, Emigrants and Immigrants, Female, Follow-Up Studies, Genome, Bacterial, Humans, Incidence, Male, Middle Aged, Molecular Epidemiology, Molecular Typing, Mycobacterium tuberculosis/classification, Mycobacterium tuberculosis/genetics, Mycobacterium tuberculosis/isolation & purification, Polymorphism, Single Nucleotide, Sequence Analysis, DNA, Switzerland/epidemiology, Tuberculosis/epidemiology, Tuberculosis/microbiology, Tuberculosis/transmission, Young Adult
Pubmed
Web of science
Open Access
Yes
Create date
06/06/2016 17:31
Last modification date
20/08/2019 16:09
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