Genotyping Analyses of Tuberculosis Cases in U.S.- and Foreign-Born Massachusetts Residents

• DOI: 10.3201/eid0811.020370
• Publication Date: 2012-06-25T19:19:38Z
• Authors: Sharon Sharnprapai; Ann C. Miller; Robert Suruki; Edward Corkren; Sue Etkind; Jeffrey Driscoll; Michael McGarry; Edward Nardell
• Keywords: Adult; DNA, Bacterial; Male; Genotype; DNA fingerprinting; 610; Infectious and parasitic diseases; RC109-216; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; emigrant; Cluster Analysis; Humans; Tuberculosis; molecular; Child; Aged; Molecular Epidemiology; Research; R; Infant; Mycobacterium tuberculosis; Emigration and Immigration; Middle Aged; DNA Fingerprinting; 3. Good health; tuberculosis; Massachusetts; Child, Preschool; Medicine; epidemiology; Female; Polymorphism, Restriction Fragment Length; cluster analysis

We used molecular genotyping to further understand the epidemiology and transmission patterns of tuberculosis (TB) in Massachusetts. The study population included 983 TB patients whose cases were verified by the Massachusetts Department of Public Health between July 1, 1996, and December 31, 2000, and for whom genotyping results and information on country of origin were available. Two hundred seventy-two (28%) of TB patients were in genetic clusters, and isolates from U.S-born were twice as likely to cluster as those of foreign-born (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.69 to 3.12). Our results suggest that restriction fragment length polymorphism analysis has limited capacity to differentiate TB strains when the isolate contains six or fewer copies of IS6110, even with spoligotyping. Clusters of TB patients with more than six copies of IS6110 were more likely to have epidemiologic connections than were clusters of TB patients with isolates with few copies of IS6110 (OR 8.01, 95%; CI 3.45 to 18.93).