Previous Article | Next Article ![]()
Journal of Clinical Microbiology, February 1998, p. 486-492, Vol. 36, No. 2
Centre National de Référence des
Mycobactéries,
Received 7 August 1997/Returned for modification 1 October
1997/Accepted 4 November 1997
Forty-three percent of the tuberculosis cases reported in France
are from the Ile de France region. The incidence of tuberculosis in
this region is 33 cases per 100,000 inhabitants, twice the national
average. A restriction fragment length polymorphism (RFLP) analysis was
performed with clinical isolates of Mycobacterium tuberculosis isolated during 1995 in 10 hospitals in Paris and surrounding areas to detect tuberculosis transmission and define the
factors associated with clustering in this population. The molecular
markers used were the insertion sequence IS6110 and the
direct repeat (DR) sequence. Social, demographic, and clinical data
were collected from the patients' medical files. Ten patients with
isolates with a single copy of IS6110 were excluded from further analysis. Twenty-four patients with false-positive cultures due
to laboratory contamination (based on RFLP analysis with
IS6110 and examination of patient data) were also excluded.
The study was then conducted with 272 strains isolated from 272 patients. Further fingerprinting was performed by using the DR element
with strains with patterns by RFLP analysis with IS6110
that differed by one band only and strains with identical patterns by
RFLP analysis with IS6110 and with low numbers of copies of
IS6110. The combined use of both markers identified unique
patterns for 177 strains and clustered 95 (35.7%) strains in 26 groups, each containing isolates from 2 to 12 patients. The clustering
was strongly associated with homelessness and the male sex. It was not
associated with age, birth in a foreign country, human immunodeficiency
virus positivity, or residence in hostels or prison. Isolates from
homeless people were often included in large clusters, and homeless
people could be the source of tuberculosis transmission for more than 50% of the clustered patients. These results suggest that homeless people play a key role in the spread of M. tuberculosis in
the community and that poor socioeconomic conditions are the main risk
factors associated with active tuberculosis transmission.
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Molecular Fingerprinting of Mycobacterium tuberculosis
and Risk Factors for Tuberculosis Transmission in Paris, France,
and Surrounding Area
*
Corresponding author. Mailing address: Centre National
de Référence des Mycobactéries, Institut Pasteur, 25 rue du Dr. Roux, 75724 Paris cedex 15, France. Phone: (33) (1)
45688360. Fax: (33) (1) 40613118. E-mail:
vvincent{at}pasteur.fr.
Journal of Clinical Microbiology, February 1998, p. 486-492, Vol. 36, No. 2
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
This article has been cited by other articles:
| Antimicrob. Agents Chemother. | Clin. Microbiol. Rev. |
|---|---|
| Clin. Vaccine Immunol. | ALL ASM JOURNALS |
|---|