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Journal of Clinical Microbiology, March 2005, p. 1228-1233, Vol. 43, No. 3
0095-1137/05/$08.00+0     doi:10.1128/JCM.43.3.1228-1233.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.

Epidemiologic Import of Tuberculosis Cases Whose Isolates Have Similar but Not Identical IS6110 Restriction Fragment Length Polymorphism Patterns

M. D. Cave,^1,2* Z. H. Yang,^1,2, R. Stefanova,^1,2,3 N. Fomukong,^1,2 K. Ijaz,^3, J. Bates,^1,2,3 and K. D. Eisenach^1,2

Regional Genotyping Laboratory, Central Arkansas Veterans Healthcare System,¹ University of Arkansas for Medical Sciences,² Arkansas Department of Health, Little Rock, Arkansas³

Received 3 August 2004/ Returned for modification 15 September 2004/ Accepted 5 November 2004

Isolates of Mycobacterium tuberculosis from patients with epidemiologic links frequently demonstrate identical IS6110 restriction fragment length polymorphism (RFLP) patterns (i.e., RFLP clustering) because they are infected with the same strain. Uncertainty arises with isolates that differ from one another by a few IS6110 hybridizing bands. During the period from 1 January 1996 to 31 December 1999, isolates from 585 tuberculosis (TB) cases were analyzed by RFLP, representing 98.2% of the 596 culture-positive TB cases reported in Arkansas during the study period. Of the 585 cases for which RFLP was available, 419 (71.6%) had an RFLP pattern with more than five copies of IS6110. Of the total 74 clusters, 48 comprised isolates with more than five copies of IS6110 and included 164 cases. Sixty-nine isolates with more than five copies of IS6110 comprising 16 clusters and 60 unique isolates were found to be similar to at least 1 other isolate (differing from it by one or two hybridizing bands). Among the 129 cases whose isolates were similar to other clustered or unique isolates, 16 cases were discovered with epidemiologic links: 14 (15.2%) were among the 92 cases with IS6110 RFLP patterns similar to those in clusters, and 2 (5.2%) were among the 37 unique cases that were similar to another unique case. The isolates from the epidemiologically linked patients shared common spoligotypes; all except one case shared common polymorphic GC-rich sequence (PGRS) patterns. Of the 129 patients whose isolates differed from another by one or two hybridizing IS6110 bands, 101 (78.3%) shared common spoligotypes and 87 (67.4%) shared common PGRS RFLP patterns.

Present address: School of Public Health, University of Michigan, Ann Arbor, Mich.

Present address: Centers for Disease Control and Prevention, Atlanta, Ga.

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