Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
PLoS One. 2019 Mar 13;14(3):e0210080. doi: 10.1371/journal.pone.0210080. eCollection 2019.
Molecular typing and whole genome sequencing (WGS) information is used for (inter-) national outbreak investigations. To assist the implementation of these techniques for tuberculosis (TB) surveillance and outbreak investigations at European level there is a need for inter-country collaboration and standardization. This demands more information on molecular typing practices and capabilities of individual countries. We aimed to review the use of molecular/genomic typing for TB surveillance in European Union and European Economic Area countries in 2016; assess its public health value; and collect experiences on typing data use for cross-border cluster investigations.
A web-based questionnaire was provided to all TB National Focal Points. The questionnaire consisted of three parts: i) Use and integration of molecular and genomic typing data into TB surveillance; ii) Cross-border cluster investigation and international collaboration, and iii) Perception and evaluation of public health benefits of molecular and genomic typing for TB surveillance.
Of 26 responding countries, 20 used molecular typing for TB surveillance, including nine applying WGS. The level of integration into the national surveillance was heterogeneous. Among six countries not using typing for TB surveillance, more than half planned its implementation soon. Overall, most countries perceived an added public health value of molecular typing for TB control. Concerning international cluster investigations, countries had little experience and did not have standard protocols to exchange typing data.
Our study shows a wide use of molecular and genomic typing data for TB surveillance in EU/EEA countries and reveals that transition to WGS-based typing is ongoing or is considered in most countries. However, our results also show a high heterogeneity in the use and integration of typing data for TB surveillance. Standardization of typing data use for TB surveillance is needed and formal procedures should be developed to facilitate international collaboration.
分子分型和全基因组测序（WGS）信息用于（国际）国家疫情调查。为了协助在欧洲一级实施这些技术用于结核病（TB）监测和疫情调查，需要国家间合作和标准化。这需要更多关于各国分子分型实践和能力的信息。我们旨在审查 2016 年欧盟和欧洲经济区国家用于结核病监测的分子/基因组分型的使用情况；评估其公共卫生价值；并收集关于用于跨境集群调查的分型数据使用经验。
向所有结核病国家联络点提供了一个基于网络的问卷。问卷包括三个部分：i）将分子和基因组分型数据纳入结核病监测的使用和整合；ii）跨境集群调查和国际合作，以及 iii）对分子和基因组分型用于结核病监测的公共卫生效益的看法和评价。
在 26 个做出回应的国家中，有 20 个国家将分子分型用于结核病监测，其中包括 9 个国家应用 WGS。整合到国家监测中的水平存在差异。在 6 个不使用分型进行结核病监测的国家中，超过一半计划很快实施。总体而言，大多数国家认为分子分型对结核病控制具有额外的公共卫生价值。关于国际集群调查，各国经验有限，没有交换分型数据的标准协议。
我们的研究表明，欧盟/欧洲经济区国家广泛使用分子和基因组分型数据进行结核病监测，并显示出大多数国家正在向基于 WGS 的分型过渡或正在考虑。然而，我们的研究结果也表明，在使用和整合分型数据进行结核病监测方面存在高度异质性。需要对分型数据用于结核病监测的使用进行标准化，并应制定正式程序以促进国际合作。
