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Journal of Clinical Microbiology, April 2001, p. 1530-1535, Vol. 39, No. 4
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.4.1530-1535.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

A Combination of Two Genetic Markers Is Sufficient for Restriction Fragment Length Polymorphism Typing of Mycobacterium tuberculosis Complex in Areas with a High Incidence of Tuberculosis

Voahangy Rasolofo-Razanamparany,1,* Herimanana Ramarokoto,2 Guy Aurégan,3,dagger Brigitte Gicquel,4 and Suzanne Chanteau1

Unité Tuberculose-Peste1 and Centre National de Référence des Mycobactéries,2 Institut Pasteur, 101 Antananarivo, and Programme National de Lutte Anti-Tuberculeuse, Ministère Santé,3 Madagascar, and Unité de Génétique Mycobactérienne, Institut Pasteur, 75724 Paris Cedex 15, France4

Received 11 July 2000/Returned for modification 17 October 2000/Accepted 26 January 2001

The incidence of tuberculosis (TB) in Madagascar is 150 cases per 100,000 people. Because of this endemicity, we studied the genetic diversity of Mycobacterium tuberculosis strains isolated in four big cities in 1994 to 1995 with the aim of monitoring TB transmission. Isolates from 316 cases of pulmonary TB (PTM+) were typed by Southern hybridization with genetic markers IS6110 and DR. Of the 316 PTM+ strains, 66 (20.8%) had a single IS6110 band and were differentiated by the DR marker into 33 profiles. Using both markers, 37.7% (119) of the patients were clustered, a proportion similar to that in countries with a high prevalence of TB. There was no significant difference between clustered and nonclustered patients in age, sex, Mycobacterium bovis BCG status, and drug susceptibility of strains. Clustering was significantly greater in the capital, Antananarivo, than in the other cities, suggesting a higher rate of transmission. However, most of the patients in clusters were living in different areas, and, within a distance of 0.7 km, we did not find epidemiologically unrelated strains with the same restriction fragment length polymorphism profile. Despite an apparently low polymorphism, genetic markers such as IS6110 are potentially valuable for monitoring TB transmission. However, the high proportion of Malagasy isolates with a single IS6110 copy makes this marker alone unsuitable for typing. Additional markers such as DR are necessary for the differentiation of the isolates and for epidemiological surveys.

* Corresponding author. Mailing address: Unité Tuberculose, Institut Pasteur, B.P. 1274, 101 Antananarivo, Madagascar. Phone: 261-20-22-401 64. Fax: 261-20-22-415 34. E-mail:vrasolof{at}pasteur.mg.

dagger Present address: Programme Lèpre/Tuberculose, Ouagadougou 01, Burkina-Faso.

Journal of Clinical Microbiology, April 2001, p. 1530-1535, Vol. 39, No. 4
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.4.1530-1535.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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Copyright © 2001 by the American Society for Microbiology. All rights reserved.