Molecular Epidemiology of Multidrug-Resistant Tuberculosis, New York City, 1995–1997

• DOI: 10.3201/eid0811.020288
• Publication Date: 2012-06-25T18:33:14Z
• Authors: Sonal S. Munsiff; Trina Bassoff; Beth Nivin; Jiehui Li; Anu Sharma; Pablo Bifani; Barun Mathema; Jeffrey Driscoll; Barry N. Kreiswirth
• Keywords: Adult; Male; Time Factors; Adolescent; Genotype; New York; Antitubercular Agents; Infectious and parasitic diseases; RC109-216; 03 medical and health sciences; Risk Factors; Drug Resistance, Multiple, Bacterial; Cluster Analysis; Humans; Tuberculosis; Child; Aged; Aged, 80 and over; Molecular Epidemiology; 0303 health sciences; Research; R; Mycobacterium tuberculosis; Middle Aged; United States; 3. Good health; Child, Preschool; Medicine; Female; New York City

From January 1, 1995, to December 31, 1997, we reviewed records of all New York City patients who had multidrug-resistant tuberculosis (MDRTB); we performed insertion sequence (IS) 6110-based DNA genotyping on the isolates. Secondary genotyping was performed for low IS6110 copy band strains. Patients with identical DNA pattern strains were considered clustered. From 1995 through 1997, MDRTB was diagnosed in 241 patients; 217 (90%) had no prior treatment history, and 166 (68.9%) were born in the United States or Puerto Rico. Compared with non-MDRTB patients, MDRTB patients were more likely to be born in the United States, have HIV infection, and work in health care. Genotyping results were available for 234 patients; 153 (65.4%) were clustered, 126 (82.3%) of them in eight clusters of >or=4 patients. Epidemiologic links were identified for 30 (12.8%) patients; most had been exposed to patients diagnosed before the study period. These strains were likely transmitted in the early 1990 s when MDRTB outbreaks and tuberculosis transmission were widespread in New York.