Department of Microbiology and Infectious Diseases, Gregorio Marañón General University Hospital, Madrid, Spain.
Instituto Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
Microbiol Spectr. 2018 Oct;6(5). doi: 10.1128/microbiolspec.MTBP-0002-2016.
The introduction of genotypic tools to analyze isolates has transformed our knowledge of the transmission dynamics of this pathogen. We discuss the development of the laboratory methods that have been applied in recent years to study the epidemiology of . This review integrates two approaches: on the one hand, it considers how genotyping techniques have evolved over the years; and on the other, it looks at how the way we think these techniques should be applied has changed. We begin by examining the application of fingerprinting tools to suspected outbreaks only, before moving on to universal genotyping schemes, and finally we describe the latest real-time strategies used in molecular epidemiology. We also analyze refined approaches to obtaining epidemiological data from patients and to increasing the discriminatory power of genotyping by techniques based on genomic characterization. Finally, we review the development of integrative solutions to reconcile the speed of PCR-based methods with the high discriminatory power of whole-genome sequencing in easily implemented formats adapted to low-resource settings. Our analysis of future considerations highlights the need to bring together the three key elements of high-quality surveillance of transmission in tuberculosis, namely, speed, precision, and ease of implementation.
基因分型工具的引入改变了我们对这种病原体传播动力学的认识。我们讨论了近年来应用于研究结核分枝杆菌流行病学的实验室方法的发展。本综述综合了两种方法：一方面，它考虑了基因分型技术多年来的发展演变；另一方面，它探讨了我们对这些技术应用方式的看法的变化。我们首先研究了仅在疑似暴发时应用指纹图谱工具，然后转向通用基因分型方案，最后描述了分子流行病学中最新的实时策略。我们还分析了从患者获得流行病学数据的精细方法，并通过基于基因组特征的技术提高基因分型的区分能力。最后，我们综述了整合解决方案的发展，以协调基于 PCR 方法的速度与全基因组测序的高区分能力，采用易于在资源有限环境中实施的格式。我们对未来考虑因素的分析强调了需要将结核分枝杆菌传播的高质量监测的三个关键要素——速度、精度和易于实施——结合起来。
