Sharnprapai Sharon, Miller Ann C, Suruki Robert, Corkren Edward, Etkind Sue, Driscoll Jeffrey, McGarry Michael, Nardell Edward
Massahusetts Department of Public Health, Boston, Massahusetts 02130, USA.
Emerg Infect Dis. 2002 Nov;8(11):1239-45. doi: 10.3201/eid0811.020370.
We used molecular genotyping to further understand the epidemiology and transmission patterns of tuberculosis (TB) in Massachusetts. The study population included 983 TB patients whose cases were verified by the Massachusetts Department of Public Health between July 1, 1996, and December 31, 2000, and for whom genotyping results and information on country of origin were available. Two hundred seventy-two (28%) of TB patients were in genetic clusters, and isolates from U.S-born were twice as likely to cluster as those of foreign-born (odds ratio [OR] 2.29, 95% confidence interval [CI] 1.69 to 3.12). Our results suggest that restriction fragment length polymorphism analysis has limited capacity to differentiate TB strains when the isolate contains six or fewer copies of IS6110, even with spoligotyping. Clusters of TB patients with more than six copies of IS6110 were more likely to have epidemiologic connections than were clusters of TB patients with isolates with few copies of IS6110 (OR 8.01, 95%; CI 3.45 to 18.93).
我们运用分子基因分型技术，以进一步了解马萨诸塞州结核病（TB）的流行病学特征及传播模式。研究对象包括983例结核病患者，其病例于1996年7月1日至2000年12月31日期间经马萨诸塞州公共卫生部核实，且具备基因分型结果及原籍国信息。272例（28%）结核病患者处于基因簇中，美国出生患者的分离株聚类可能性是外国出生患者的两倍（优势比[OR] 2.29，95%置信区间[CI] 1.69至3.12）。我们的研究结果表明，当分离株含有六个或更少拷贝的IS6110时，即使采用间隔寡核苷酸分型法，限制片段长度多态性分析区分结核菌株的能力也有限。与IS6110拷贝数少的分离株的结核病患者簇相比，IS6110拷贝数超过六个的结核病患者簇更有可能存在流行病学关联（OR 8.01，95%；CI 3.45至18.93）。
