Journal Article

Prospective Use of Molecular Typing of <i>Mycobacterium tuberculosis</i> by Use of Restriction Fragment—Length Polymorphism in a Public Tuberculosis-Control Program

Samuel J. McConkey, Michael Williams, Don Weiss, Hilda Adams, M. Donald Cave, Zhenhua Yang, Tom Lindner and Thomas C. Bailey

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 5, pages 612-619
Published in print March 2002 | ISSN: 1058-4838
Published online March 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/338785
Prospective Use of Molecular Typing of Mycobacterium tuberculosis by Use of Restriction Fragment—Length Polymorphism in a Public Tuberculosis-Control Program

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We performed a prospective, community-based evaluation of molecular typing of Mycobacterium tuberculosis isolates as a method for tuberculosis (TB) control. We performed restriction fragment—length polymorphism (RFLP) analysis of the insertion sequences IS6110 and pTBN12 for isolates recovered from 61 of 62 patients with culture-positive TB in St. Louis during 12 months. Twenty-four (39%) of the 61 patients were infected with an isolate with an RFLP pattern that was shared with ≥1 other isolate, and 11 (46%) also had epidemiologic links with patients in their cluster of cases. One case each of laboratory cross-contamination and occupational transmission were discovered. The patients in clusters were more likely to be younger, black, United States—born, to have substance abuse problems, and to live in poorer areas. A predictive algorithm for molecular identification of clusters had a sensitivity and a specificity of 75%. This study allowed the TB-control program in St. Louis to be redirected toward the affected subpopulations.

Journal Article.  4727 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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