The molecular epidemiology of Mycobacterium tuberculosis in north London

摘要: It is estimated that one third of the world‘s population are infected with bacterium M. tuberculosis and approximately 9.4 million new cases were diagnosed globally in 2008. Molecular tools, developed over previous two decades, have allowed further in-depth study this historic disease. Genotyping allows evolutionary relationships well as routes transmission organism between hosts. The pairing genotyping demographic data analysis current trends disease within a given patient population. Two methodologies (IS6110 RFLP Mycobacterial Interspersed Repetitive Units – Variable Number Tandem Repeats (MIRU-VNTR)), alongside been utilised for TB at Royal Free Hospital, London. shows largely concordant seen London whole; majority patients being born outside UK drug resistance rates higher than national average. The acquisition resistance-conferring mutations by often presumed to be associated fitness cost. Here we investigate isolates from outbreaks involving large numbers resistant strains. first group strains was found part ongoing north isoniazid outbreak. suggests outbreak consists successful, closely related, circulating heterogeneous profiles little or no relationship biology organisms isolated cohort who underwent novel diagnostic interferon gamma release assay investigated. Genotyping, ESAT-6 gene sequencing expression assays suggest varying immune response individuals driven host factors rather characteristic strain tuberculosis. This geographic location home diverse low rate transmission. characteristics whole. These findings show critically important identification suspected contamination events investigation successful related phenotypes. can augment classic epidemiology clinical practice provide holistic approach investigation, treatment control global health problem. Understanding genomics how enormous burden will tackled.