This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Drobniewski, F. A.
Right arrow Articles by Yates, M. D.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Drobniewski, F. A.
Right arrow Articles by Yates, M. D.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, May 2003, p. 1861-1868, Vol. 41, No. 5
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.5.1861-1868.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Evaluation and Utilization as a Public Health Tool of a National Molecular Epidemiological Tuberculosis Outbreak Database within the United Kingdom from 1997 to 2001

F. A. Drobniewski,* A. Gibson, M. Ruddy, and M. D. Yates

Public Health Laboratory Service Mycobacterium Reference Unit and Regional Center for Mycobacteriology, Department of Infection, GKT School of Medicine, King's College Hospital (Dulwich), London SE22 8QF, United Kingdom

Received 9 August 2002/ Returned for modification 28 October 2002/ Accepted 7 February 2003

The aim of this study was to develop a national model and analyze the value of a molecular epidemiological Mycobacterium tuberculosis DNA fingerprint-outbreak database. Incidents were investigated by the United Kingdom PHLS Mycobacterium Reference Unit (MRU) from June 1997 to December 2001, inclusive. A total of 124 incidents involving 972 tuberculosis cases, including 520 patient cultures from referred incidents and 452 patient cultures related to two population studies, were examined by using restriction fragment length polymorphism IS6110 fingerprinting and rapid epidemiological typing. Investigations were divided into the following three categories, reflecting different operational strategies: retrospective passive analysis, retrospective active analysis, and retrospective prospective analysis. The majority of incidents were in the retrospective passive analysis category, i.e., the individual submitting isolates has a suspicion they may be linked. Outbreaks were examined in schools, hospitals, farms, prisons, and public houses, and laboratory cross-contamination events and unusual clinical presentations were investigated. Retrospective active analysis involved a major outbreak centered on a high school. Contact tracing of a teenager with smear-positive pulmonary tuberculosis matched 14 individuals, including members of his class, and another 60 cases were identified in schools clinically and radiologically and by skin testing. Retrospective prospective analysis involved an outbreak of 94 isoniazid-resistant tuberculosis cases in London, United Kingdom, that began after cases were identified at one hospital in January 2000. Contact tracing and comparison with MRU databases indicated that the earliest matched case had occurred in 1995. Subsequently, the MRU changed to an active prospective analysis targeting linked isoniazid-monoresistant isolates for follow up. The patients were multiethnic, born mainly in the United Kingdom, and included professionals, individuals from the music industry, intravenous drug abusers, and prisoners.

* Corresponding author. Mailing address: PHLS Mycobacterium Reference Unit and Regional Center for Mycobacteriology, Department of Infection, GKT School of Medicine, King's College Hospital (Dulwich), East Dulwich Grove, London SE22 8QF, United Kingdom. Phone: 0208-693-1312. Fax: 0207-346-6477. E-mail: francis.drobniewski{at}kcl.ac.uk.

Journal of Clinical Microbiology, May 2003, p. 1861-1868, Vol. 41, No. 5
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.5.1861-1868.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Stein-Zamir, C., Volovik, I., Rishpon, S., Atamna, A., Lavy, A., Weiler-Ravell, D. (2006). Tuberculosis outbreak among students in a boarding school. Eur Respir J 28: 986-991 [Abstract] [Full Text]  
  • Gopaul, K. K., Brown, T. J., Gibson, A. L., Yates, M. D., Drobniewski, F. A. (2006). Progression Toward an Improved DNA Amplification-Based Typing Technique in the Study of Mycobacterium tuberculosis Epidemiology.. J. Clin. Microbiol. 44: 2492-2498 [Abstract] [Full Text]  
  • Rajakumar, K., Shafi, J., Smith, R. J., Stabler, R. A., Andrew, P. W., Modha, D., Bryant, G., Monk, P., Hinds, J., Butcher, P. D., Barer, M. R. (2004). Use of Genome Level-Informed PCR as a New Investigational Approach for Analysis of Outbreak-Associated Mycobacterium tuberculosis Isolates. J. Clin. Microbiol. 42: 1890-1896 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»