Agarwal Saroochi, Nguyen Duc T, Teeter Larry D, Graviss Edward A
, Houston Methodist Research Institute, Houston, Texas, USA.
Forensic Research and Analysis, 425 NW 10th Avenue, Ste 306, Portland, OR, 97209, USA.
BMC Infect Dis. 2017 May 31;17(1):378. doi: 10.1186/s12879-017-2480-z.
Harris County, Texas is the third most populous county in the United States and consistently has tuberculosis rates above the national average. Understanding jurisdictional epidemiologic characteristics for the most common Mycobacterium tuberculosis genotyped clusters is needed for tuberculosis prevention programs. Our objective is to describe the demographic, laboratory, clinical, temporal and geospatial characteristics for the most common Mycobacterium tuberculosis GENType clusters in Harris County from 2009 to 2015.
We analyzed data from the Centers for Disease Control and Prevention (CDC) Tuberculosis Genotyping Information Management System (TB GIMS). Chi-square analyses were used to determine associations between selected clusters and specific characteristics of interest. Geographical Information System (GIS) point density and hot spot maps were generated and analyzed with ArcGIS 10.4.
In Harris County from 2009 to 2015, 1655 of 1705 (97.1%) culture positive tuberculosis cases were genotyped and assigned a GENType, and 1058 different GENTypes were identified. The analyzed genotype clusters represent 14.1% (233/1655) of all genotyped cases: G00010 (n = 118), G00014 (n = 38), G00769 (n = 33), G01521 (n = 26), and G08964 (n = 18). Male gender (p = 0.002), ethnicity (p < 0.001), homelessness (p < 0.001), excessive alcohol use (p = 0.002), and U.S.-birth (p = 0.004) were associated with the 5 GENTypes. Hot and cold spots were identified as geographic areas having high and low TB incidence.
Of more than 1000 distinct GENTypes identified in Harris County, there were 5 common Mycobacterium tuberculosis GENType clusters seen from 2009 to 2015. The common genotypes were observed primarily in U.S.-born populations despite the large foreign-born population residing in Harris County. GENType was significant distributed spatially and temporally in Harris County in the analyzed time period indicating that there may be outbreaks caused by transmission.
得克萨斯州哈里斯县是美国人口第三多的县，结核病发病率一直高于全国平均水平。结核病预防项目需要了解最常见的结核分枝杆菌基因分型簇的辖区流行病学特征。我们的目标是描述2009年至2015年哈里斯县最常见的结核分枝杆菌基因分型簇的人口统计学、实验室、临床、时间和地理空间特征。
我们分析了疾病控制与预防中心（CDC）结核病基因分型信息管理系统（TB GIMS）的数据。采用卡方分析来确定选定的基因分型簇与感兴趣的特定特征之间的关联。使用ArcGIS 10.4生成并分析地理信息系统（GIS）点密度图和热点图。
2009年至2015年在哈里斯县，1705例培养阳性结核病病例中有1655例（97.1%）进行了基因分型并被指定了一个基因分型，共识别出1058种不同的基因分型。分析的基因分型簇占所有基因分型病例的14.1%（233/1655）：G00010（n = 118）、G00014（n = 38）、G00769（n = 33）、G01521（n = 26）和G08964（n = 18）。男性（p = 0.002）、种族（p < 0.001）、无家可归（p < 0.001）、过度饮酒（p = 0.002）和在美国出生（p = 0.004）与这5种基因分型相关。确定了结核病发病率高和低的地理区域为热点和冷点地区。
在哈里斯县识别出的1000多种不同的基因分型中，2009年至2015年出现了5个常见的结核分枝杆菌基因分型簇。尽管哈里斯县有大量外国出生人口，但常见基因型主要在美国出生人群中观察到。在分析时间段内，基因分型在哈里斯县存在显著的空间和时间分布，表明可能存在传播引起的疫情。
