Clustered tuberculosis in a low-burden country: nationwide genotyping through 15 years

Zaza Kamper-Jørgensen, A B Andersen, A Kok-Jensen, Ib Christian Bygbjerg, P H Andersen, V O Thomsen, Mads Kamper-Jørgensen, T Lillebaek

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Molecular genotyping of Mycobacterium tuberculosis has proved to be a powerful tool in tuberculosis surveillance, epidemiology, and control. Based on results obtained through 15 years of nationwide IS6110 restriction fragment length polymorphism (RFLP) genotyping of M. tuberculosis cases in Denmark, a country on the way toward tuberculosis elimination, we discuss M. tuberculosis transmission dynamics and point to areas for control interventions. Cases with 100% identical genotypes (RFLP patterns) were defined as clustered, and a cluster was defined as cases with an identical genotype. Of 4,601 included cases, corresponding to 76% of reported and 97% of culture-verified tuberculosis cases in the country, 56% were clustered, of which 69% were Danes. Generally, Danes were more often in large clusters (≥ 50 persons), older (mean age, 45 years), and male (male/female ratio, 2.5). Also, Danes had a higher cluster frequency within a 2-year observation window (60.8%), and higher clustering rate of new patterns over time, compared to immigrants. A dominant genotype, cluster 2, constituted 44% of all clustered and 35% of all genotyped cases. This cluster was primarily found among Danish males, 30 to 59 years of age, often socially marginalized, and with records of alcohol abuse. In Danes, cluster 2 alone was responsible for the high cluster frequency level. Immigrants had a higher incidence of clustered tuberculosis at a younger age (0 to 39 years). To achieve tuberculosis elimination in Denmark, high-risk transmission environments, like the cluster 2 environment in Danes, and specific transmission chains in immigrants in the capital area, e.g., homeless/socially marginalized Somalis/Greenlanders, often with alcohol abuse, must be targeted, including groups with a high risk of reactivation.
OriginalsprogEngelsk
TidsskriftJournal of Clinical Microbiology
Vol/bind50
Udgave nummer8
Sider (fra-til)2660-7
Antal sider8
ISSN0095-1137
DOI
StatusUdgivet - 2012

Fingeraftryk

Mycobacterium tuberculosis
Denmark
Restriction Fragment Length Polymorphisms
Alcoholism
Cluster Analysis
Epidemiology
Observation
Incidence

Citer dette

Kamper-Jørgensen, Z., Andersen, A. B., Kok-Jensen, A., Bygbjerg, I. C., Andersen, P. H., Thomsen, V. O., ... Lillebaek, T. (2012). Clustered tuberculosis in a low-burden country: nationwide genotyping through 15 years. Journal of Clinical Microbiology, 50(8), 2660-7. https://doi.org/10.1128/JCM.06358-11
Kamper-Jørgensen, Zaza ; Andersen, A B ; Kok-Jensen, A ; Bygbjerg, Ib Christian ; Andersen, P H ; Thomsen, V O ; Kamper-Jørgensen, Mads ; Lillebaek, T. / Clustered tuberculosis in a low-burden country : nationwide genotyping through 15 years. I: Journal of Clinical Microbiology. 2012 ; Bind 50, Nr. 8. s. 2660-7.
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abstract = "Molecular genotyping of Mycobacterium tuberculosis has proved to be a powerful tool in tuberculosis surveillance, epidemiology, and control. Based on results obtained through 15 years of nationwide IS6110 restriction fragment length polymorphism (RFLP) genotyping of M. tuberculosis cases in Denmark, a country on the way toward tuberculosis elimination, we discuss M. tuberculosis transmission dynamics and point to areas for control interventions. Cases with 100{\%} identical genotypes (RFLP patterns) were defined as clustered, and a cluster was defined as cases with an identical genotype. Of 4,601 included cases, corresponding to 76{\%} of reported and 97{\%} of culture-verified tuberculosis cases in the country, 56{\%} were clustered, of which 69{\%} were Danes. Generally, Danes were more often in large clusters (≥ 50 persons), older (mean age, 45 years), and male (male/female ratio, 2.5). Also, Danes had a higher cluster frequency within a 2-year observation window (60.8{\%}), and higher clustering rate of new patterns over time, compared to immigrants. A dominant genotype, cluster 2, constituted 44{\%} of all clustered and 35{\%} of all genotyped cases. This cluster was primarily found among Danish males, 30 to 59 years of age, often socially marginalized, and with records of alcohol abuse. In Danes, cluster 2 alone was responsible for the high cluster frequency level. Immigrants had a higher incidence of clustered tuberculosis at a younger age (0 to 39 years). To achieve tuberculosis elimination in Denmark, high-risk transmission environments, like the cluster 2 environment in Danes, and specific transmission chains in immigrants in the capital area, e.g., homeless/socially marginalized Somalis/Greenlanders, often with alcohol abuse, must be targeted, including groups with a high risk of reactivation.",
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Kamper-Jørgensen, Z, Andersen, AB, Kok-Jensen, A, Bygbjerg, IC, Andersen, PH, Thomsen, VO, Kamper-Jørgensen, M & Lillebaek, T 2012, 'Clustered tuberculosis in a low-burden country: nationwide genotyping through 15 years', Journal of Clinical Microbiology, bind 50, nr. 8, s. 2660-7. https://doi.org/10.1128/JCM.06358-11

Clustered tuberculosis in a low-burden country : nationwide genotyping through 15 years. / Kamper-Jørgensen, Zaza; Andersen, A B; Kok-Jensen, A; Bygbjerg, Ib Christian; Andersen, P H; Thomsen, V O; Kamper-Jørgensen, Mads; Lillebaek, T.

I: Journal of Clinical Microbiology, Bind 50, Nr. 8, 2012, s. 2660-7.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Clustered tuberculosis in a low-burden country

T2 - nationwide genotyping through 15 years

AU - Kamper-Jørgensen, Zaza

AU - Andersen, A B

AU - Kok-Jensen, A

AU - Bygbjerg, Ib Christian

AU - Andersen, P H

AU - Thomsen, V O

AU - Kamper-Jørgensen, Mads

AU - Lillebaek, T

PY - 2012

Y1 - 2012

N2 - Molecular genotyping of Mycobacterium tuberculosis has proved to be a powerful tool in tuberculosis surveillance, epidemiology, and control. Based on results obtained through 15 years of nationwide IS6110 restriction fragment length polymorphism (RFLP) genotyping of M. tuberculosis cases in Denmark, a country on the way toward tuberculosis elimination, we discuss M. tuberculosis transmission dynamics and point to areas for control interventions. Cases with 100% identical genotypes (RFLP patterns) were defined as clustered, and a cluster was defined as cases with an identical genotype. Of 4,601 included cases, corresponding to 76% of reported and 97% of culture-verified tuberculosis cases in the country, 56% were clustered, of which 69% were Danes. Generally, Danes were more often in large clusters (≥ 50 persons), older (mean age, 45 years), and male (male/female ratio, 2.5). Also, Danes had a higher cluster frequency within a 2-year observation window (60.8%), and higher clustering rate of new patterns over time, compared to immigrants. A dominant genotype, cluster 2, constituted 44% of all clustered and 35% of all genotyped cases. This cluster was primarily found among Danish males, 30 to 59 years of age, often socially marginalized, and with records of alcohol abuse. In Danes, cluster 2 alone was responsible for the high cluster frequency level. Immigrants had a higher incidence of clustered tuberculosis at a younger age (0 to 39 years). To achieve tuberculosis elimination in Denmark, high-risk transmission environments, like the cluster 2 environment in Danes, and specific transmission chains in immigrants in the capital area, e.g., homeless/socially marginalized Somalis/Greenlanders, often with alcohol abuse, must be targeted, including groups with a high risk of reactivation.

AB - Molecular genotyping of Mycobacterium tuberculosis has proved to be a powerful tool in tuberculosis surveillance, epidemiology, and control. Based on results obtained through 15 years of nationwide IS6110 restriction fragment length polymorphism (RFLP) genotyping of M. tuberculosis cases in Denmark, a country on the way toward tuberculosis elimination, we discuss M. tuberculosis transmission dynamics and point to areas for control interventions. Cases with 100% identical genotypes (RFLP patterns) were defined as clustered, and a cluster was defined as cases with an identical genotype. Of 4,601 included cases, corresponding to 76% of reported and 97% of culture-verified tuberculosis cases in the country, 56% were clustered, of which 69% were Danes. Generally, Danes were more often in large clusters (≥ 50 persons), older (mean age, 45 years), and male (male/female ratio, 2.5). Also, Danes had a higher cluster frequency within a 2-year observation window (60.8%), and higher clustering rate of new patterns over time, compared to immigrants. A dominant genotype, cluster 2, constituted 44% of all clustered and 35% of all genotyped cases. This cluster was primarily found among Danish males, 30 to 59 years of age, often socially marginalized, and with records of alcohol abuse. In Danes, cluster 2 alone was responsible for the high cluster frequency level. Immigrants had a higher incidence of clustered tuberculosis at a younger age (0 to 39 years). To achieve tuberculosis elimination in Denmark, high-risk transmission environments, like the cluster 2 environment in Danes, and specific transmission chains in immigrants in the capital area, e.g., homeless/socially marginalized Somalis/Greenlanders, often with alcohol abuse, must be targeted, including groups with a high risk of reactivation.

U2 - 10.1128/JCM.06358-11

DO - 10.1128/JCM.06358-11

M3 - Journal article

C2 - 22675129

VL - 50

SP - 2660

EP - 2667

JO - Journal of Clinical Microbiology

JF - Journal of Clinical Microbiology

SN - 0095-1137

IS - 8

ER -

Kamper-Jørgensen Z, Andersen AB, Kok-Jensen A, Bygbjerg IC, Andersen PH, Thomsen VO et al. Clustered tuberculosis in a low-burden country: nationwide genotyping through 15 years. Journal of Clinical Microbiology. 2012;50(8):2660-7. https://doi.org/10.1128/JCM.06358-11