A computer-assisted molecular epidemiologic approach to confronting the reemergence of tuberculosis.

Molecular epidemiologic approaches have provided important insights into the pathogenesis and epidemiology of tuberculosis. However, continued progress in this field will be reliant on the development of computerized information management systems capable of analyzing large numbers of bacterial DNA fingerprints and incorporating this with data collected as part of conventional disease surveillance. The specific attributes of these computer systems must be tailored to the nature and scope of the research question. In this article, the authors describe a system being used for the surveillance of Mycobacterium tuberculosis strains in San Francisco. The current performance characteristics are described, and potential future developmental directions are outlined. This system demonstrates several general principles of computerized molecular epidemiology that are likely to be of increasing applicability to a variety of pathogens.