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Journal of Clinical Microbiology, August 2006, p. 2890-2896, Vol. 44, No. 8
0095-1137/06/$08.00+0     doi:10.1128/JCM.00160-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Strain-Specific Differences in Two Large Mycobacterium tuberculosis Genotype Clusters in Isolates Collected from Homeless Patients in New York City from 2001 to 2004

Michelle Macaraig,1* Tracy Agerton,1,2 Cynthia R. Driver,1 Sonal S. Munsiff,1,2 Jalaa' Abdelwahab,2 Julie Park,1 Barry Kreiswirth,3 Jeffrey Driscoll,4 and Benyang Zhao1

New York City Department of Health and Mental Hygiene, New York, New York,1 Centers for Disease Control and Prevention, Atlanta, Georgia,2 Public Health Research Institute, Newark, New Jersey,3 Wadsworth Center, New York State Department of Health, Albany, New York4

Received 24 January 2006/ Returned for modification 29 April 2006/ Accepted 14 June 2006

We studied two large Mycobacterium tuberculosis genotype clusters associated with recent outbreaks in homeless persons to determine factors associated with these tuberculosis (TB) strains. Isolates from all culture-positive TB cases diagnosed from 1 January 2001 to 31 December 2004 were genotyped. Patients whose isolates had identical restriction fragment length polymorphism patterns and spoligotypes were considered clustered. Health department records were reviewed and reinterviews attempted for clustered cases. Patients with the Cs30 and BEs75 strains were compared to other genotypically clustered cases and to each other. The two largest genotype clusters among homeless persons were the Cs30 strain (n = 105) and the BEs75 strain (n = 47). Fifty-one (49%) patients with the Cs30 strain and 28 (60%) with the BEs75 strain were homeless. Compared to patients with the BEs75 strain, patients with the Cs30 strain were less likely to be respiratory acid-fast bacillus smear positive (51% versus 72%). Furthermore, patients with the BEs75 strain were more likely to be HIV infected (74% versus 42%), which suggests that most patients with this strain advanced to disease after recent infection. Cases in clusters of strains that have been circulating in the community over a long time period, such as the Cs30 strain, require additional investigation to determine whether clustering is a result of recent transmission or reactivation of remote infection.

* Corresponding author. Mailing address: New York City Department of Health and Mental Hygiene, 225 Broadway, 22nd Floor, New York, NY 10007. Phone: (212) 442-9932. Fax: (212) 442-9997. E-mail: mmacarai{at}health.nyc.gov.

Journal of Clinical Microbiology, August 2006, p. 2890-2896, Vol. 44, No. 8
0095-1137/06/$08.00+0     doi:10.1128/JCM.00160-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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