| A geographically-restricted but prevalent Mycobacterium tuberculosis strain identified in the West Midlands Region of the UK between 1995 and 2008. | |
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MedLine Citation:
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PMID: 21464965 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We describe the identification of, and risk factors for, the single most prevalent Mycobacterium tuberculosis strain in the West Midlands region of the UK. METHODOLOGY/PRINCIPAL FINDINGS: Prospective 15-locus MIRU-VNTR genotyping of all M. tuberculosis isolates in the West Midlands between 2004 and 2008 was undertaken. Two retrospective epidemiological investigations were also undertaken using univariable and multivariable logistic regression analysis. The first study of all TB patients in the West Midlands between 2004 and 2008 identified a single prevalent strain in each of the study years (total 155/3,056 (5%) isolates). This prevalent MIRU-VNTR profile (32333 2432515314 434443183) remained clustered after typing with an additional 9-loci MIRU-VNTR and spoligotyping. The majority of these patients (122/155, 79%) resided in three major cities located within a 40 km radius. From the apparent geographical restriction, we have named this the "Mercian" strain. A multivariate analysis of all TB patients in the West Midlands identified that infection with a Mercian strain was significantly associated with being UK-born (OR = 9.03, 95%CI = 4.56-17.87, p<0.01), Black Caribbean (OR = 5.68, 95%CI = 2.96-10.91, p < 0.01) resident in Wolverhampton (OR = 9.29, 95%CI = 5.69-15.19, p < 0.01) and negatively associated with age >65 years old (OR = 0.25, 95% CI = 0.09-0.67, p < 0.01). A second more detailed investigation analyzed a cohort of 82 patients resident in Wolverhampton between 2003 and 2006. A significant association with being born in the UK remained after a multivariate analysis (OR = 9.68, 95% CI = 2.00-46.78, p < 0.01) and excess alcohol intake and cannabis use (OR = 6.26, 95%CI = 1.45-27.02, p = .01) were observed as social risk factors for infection. CONCLUSIONS/SIGNIFICANCE: The continued consistent presence of the Mercian strain suggests ongoing community transmission. Whilst significant associations have been found, there may be other common risk factors yet to be identified. Future investigations should focus on targeting the relevant risk groups and elucidating the biological factors that mediate continued transmission of this strain. |
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Authors:
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Jason T Evans; Robert L Serafino Wani; Laura Anderson; Andrea L Gibson; E Grace Smith; Annette Wood; Babatunde Olowokure; Ibrahim Abubakar; Jonathan S Mann; Sarah Gardiner; Helen Jones; Pam Sonnenberg; Peter M Hawkey |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-03-25 |
Journal Detail:
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Title: PloS one Volume: 6 ISSN: 1932-6203 ISO Abbreviation: PLoS ONE Publication Date: 2011 |
Date Detail:
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Created Date: 2011-04-05 Completed Date: 2011-07-18 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 101285081 Medline TA: PLoS One Country: United States |
Other Details:
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Languages: eng Pagination: e17930 Citation Subset: IM |
Affiliation:
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Health Protection Agency West Midlands Laboratory, Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham, United Kingdom. jason.evans@heartofengland.nhs.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cities
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epidemiology Demography Geography* Great Britain / epidemiology Humans Incidence Minisatellite Repeats / genetics Multivariate Analysis Mycobacterium tuberculosis / genetics, isolation & purification* Polymorphism, Restriction Fragment Length Prevalence Reproducibility of Results Tuberculosis / epidemiology, microbiology |
| Grant Support | |
ID/Acronym/Agency:
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//Department of Health |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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