Molecular epidemiology of Mycobacterium tuberculosis clinical isolates in Southwest Ireland |
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| Authors: | Olabisi O Ojo Stella Sheehan Daniel G Corcoran Vladyslav Nikolayevsky Timothy Brown Margaret O'Sullivan Kathleen O'Sullivan Stephen V Gordon Francis Drobniewski Michael B Prentice |
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| Institution: | 1. Department of Microbiology, University College Cork, Cork, Ireland;2. Department of Medical Microbiology, Cork University Hospital, Cork, Ireland;3. Health Protection Agency Mycobacterium Reference Laboratory, Whitechapel, London, UK;4. Department of Public Health, Health Service Executive, Cork, Ireland;5. Department of Statistics, University College Cork, Ireland;6. Conway Institute of Biomolecular and Biomedical Science, University College Dublin, Ireland;7. Department of Pathology, University College Cork, Cork, Ireland;1. Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland;6. Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland;3. Department of Medicine, University of Puerto Rico/MD Anderson Cancer Center Partnership for Excellence in Cancer Research, San Juan, Puerto Rico;4. School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico;5. Utrecht Medical Center, Utrecht, The Netherlands;1. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA;2. Department of Medicine, University of California, San Diego, La Jolla, CA, USA;3. Department of Cardiology, Dupuytren University Hospital, Limoges, France;4. Inserm 1094, Tropical Neuroepidemiology, University of Limoges, Limoges, France;6. Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;5. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA;7. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA;1. From the Airway Disease Section, National Heart & Lung Institute, Imperial College London, London, England;1. Hospital Saint-Louis, Assistance Publique Hôpitaux de Paris, INSERM 1131, University Paris 7, Paris, France;;2. Team methods, Epidemiology and Statistics Sorbonne Paris Cité Research Centre, Unité Mixte de Recherche 1153, INSERM, Paris Descartes University, Paris, France;;3. Epidemiology Center, Assistance Publique Hôpitaux de Paris, Hôpital Hôtel-Dieu, Paris, France;;4. Division of Hematology/Oncology, Department of Internal Medicine, San Raffaele Hospital, Milan, Italy;;5. Department of Hematology, San Martino Hospital, Genoa, Italy;;6. Department of Hematology, Civil Hospital, Pescara, Italy;;7. Division of Hematology, Department of Internal Medicine, Dresden University Hospital, Dresden, Germany;;8. Department Hematology, Paoli Calmettes Institute, Marseille, France;;9. Hematologic Oncology and Bone Marrow Transplantation Unit, Anadolu Medical Center Hospital, Kocaeli, Turkey;;10. Division of Hematology/Oncology, Asturias Central University Hospital, Oviedo, Spain;;11. Department of Hematology, Lyon Sud Hospital, Lyon, France;;12. Division of Hematology and Clinical Immunology, Perugia University, Perugia, Italy;;13. European Group for Blood and Marrow Transplantation Data Office, Leiden, The Netherlands;;14. Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium;;15. Department of Internal Medicine, Hospital Santa Creu i Sant Pau, Barcelona, Spain;;16. A.Z. Sint-Jan, Brugge, Belgium;;17. Division of Hematology/Oncology, Department of Internal Medicine, University of Heidelberg, Heidelberg, Germany;;18. Department of Hematology, Gregorio Marañon General University Hospital, Madrid, Spain;;19. Department of Hematology/Immunology/Oncology, Universität Tübingen, Tübingen, Germany;;20. Department of Hematology, Hospital Reina Sofia Córdoba Hospital, Córdoba, Spain;;21. Department of Hematology and Oncology, University Hospital Leipzig, Leipzig, Germany;;22. Department of Hematology, First Affiliated Hospital, Zhejiang University, Hangzhou Zhejiang, China;;23. Department of Hematology, Netcare Pretoria East Hospital, Pretoria Gauteng, South Africa;;24. Department of Hematopoietic Diseases, Radboud University Medical Center, Nijmegen, The Netherlands;;25. Stem Cell Transplant Unit, Medical Park Hospitals, Antalya, Turkey; and;26. Department of Hematology/Oncology, University Hospital Eppendorf, Hamburg, Germany |
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| Abstract: | Tuberculosis has had significant effects on Ireland over the past two centuries, causing persistently higher morbidity and mortality than in neighbouring countries until the last decade. This study describes the results of genotyping and drug susceptibility testing of 171 strains of Mycobacterium tuberculosis complex isolated between January 2004 and December 2006 in a region of Ireland centred on the city of Cork. Spoligotype comparisons were made with the SpolDB4 database and clustered 130 strains in 23 groups, forty-one strains showed unique Spoligotyping patterns. The commonest spoligotypes detected were ST0137 (X2) (16.9%), and ST0351 (15.8%) (‘U’ clade). The major spoligotype clades were X (26.2%), U (19.3%), T (15.2%), Beijing (5.9%), Haarlem (4.7%), LAM (4.1%), BOVIS (1.75%), with 12.9% unassigned strains. A 24-locus VNTR genotyping produced 15 clusters containing 49 isolates, with high discrimination index (HGDI > 0.99). A combination of Spoligotyping and VNTR reduced the number of clustered isolates to 47 in 15 clusters (27.5%). This study identified ST351 as common among Irish nationals, and found a low rate of drug resistance with little evidence of transmission of drug resistant strains. Strain clustering was significantly associated with age under 55 years and Irish nationality. Only strains of Euro-American lineage formed clusters. Molecular typing did not completely coincide with the results of contact investigations. |
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