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Journal of Clinical Microbiology, March 2004, p. 1064-1068, Vol. 42, No. 3
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.3.1064-1068.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Expanded Geographical Distribution of the N Family of Mycobacterium tuberculosis Strains within the United States

S. Joy Milan,1 Kirsten A. Hauge,1 Natalia E. Kurepina,2 Kathryn H. Lofy,3 Stefan V. Goldberg,4 Masahiro Narita,4 Charles M. Nolan,4 Peter D. McElroy,5 Barry N. Kreiswirth,2 and Gerard A. Cangelosi1*

Seattle Biomedical Research Institute,1 Seattle-King County Public Health Department, Seattle, Washington,4 Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention,3 Centers for Disease Control and Prevention, Atlanta, Georgia,5 The Public Health Research Institute at the International Center for Public Health, Newark, New Jersey2

Received 15 September 2003/ Returned for modification 10 November 2003/ Accepted 19 November 2003

The N and W-Beijing families of Mycobacterium tuberculosis are phylogenetically closely related. The ability of the W-Beijing family to rapidly cause widespread disease is well described; however, few outbreaks involving the N family have been reported outside the New York City, N.Y., area. During 2002 to 2003, Seattle, Wash., experienced a rapidly expanding tuberculosis outbreak involving 38 persons in a 23-month period. The outbreak strain, SBRI9, exhibited the genotypic properties of the N family. Its IS6110 restriction fragment length polymorphism pattern was identical or nearly identical to those of two N family strains that were responsible for clusters of tuberculosis cases, including a large nosocomial outbreak, in New York City and New Jersey from 1989 to 1990. It was also identical to strains involved in late 1990s tuberculosis cases in Michigan, Maryland, and Arkansas. Further monitoring of the N family may show that it shares with the W-Beijing family the propensity to spread rapidly, suggesting that this characteristic evolved prior to the divergence of the two genetic lineages.

* Corresponding author. Mailing address: Seattle Biomedical Research Institute, 4 Nickerson St., Suite 200, Seattle, WA 98107-1651. Phone: (206) 284-8846, ext. 313. Fax: (206) 284-0313. E-mail: gcang{at}sbri.org.

Journal of Clinical Microbiology, March 2004, p. 1064-1068, Vol. 42, No. 3
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.3.1064-1068.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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