Evaluation of 24-locus MIRU-VNTR genotyping in Mycobacterium tuberculosis cluster investigations in four jurisdictions in the United States, 2006–2010

• Published in: Tuberculosis (Edinburgh, Scotland) Vol. 106; pp. 9 - 15
• Main Authors: Teeter, Larry D, Kammerer, J. Steven, Ghosh, Smita, Nguyen, Duc T.M, Vempaty, Padmaja, Tapia, Jane, Miramontes, Roque, Cronin, Wendy A, Graviss, Edward A
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.09.2017; Elsevier Science Ltd
• Subjects: Adult; Bacteria; Bacteriological Techniques; Cluster Analysis; Cluster investigation; Clusters; Disease control; Disease transmission; Epidemiology; Female; Genetic Loci; Genotype; Genotype & phenotype; Genotyping; HIV; Human immunodeficiency virus; Humans; Infectious Disease; Interspersed Repetitive Sequences; Loci; Male; Middle Aged; Minisatellite Repeats; MIRU-VNTR; Molecular Diagnostic Techniques; Molecular Epidemiology; Mycobacterium tuberculosis; Mycobacterium tuberculosis - genetics; Mycobacterium tuberculosis - pathogenicity; Oligonucleotides; Patients; Phenotype; Predictive Value of Tests; Pulmonary/Respiratory; Spoligotype; Spoligotyping; Strain; Surveillance; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - epidemiology; Tuberculosis - microbiology; United States - epidemiology; Young Adult; United States > US; Genotype; Cluster investigation; Tuberculosis; Surveillance; MIRU-VNTR; Spoligotype
• ISSN: 1472-9792; 1873-281X
• DOI: 10.1016/j.tube.2017.05.003

Abstract The U.S. Centers for Disease Control and Prevention (CDC) uses a combination of spacer oligonucleotide typing (spoligotyping) and mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) analyses as part of the National TB Genotyping Service (NTGS). The NTGS expansion from 12-locus MIRU-VNTR (MIRU12) to 24-locus MIRU-VNTR (MIRU24) in 2009 enhanced the ability to discriminate Mycobacterium tuberculosis strains. In the current study, we investigated the MIRU24 concordance among epidemiologic-linked tuberculosis (TB) patients in four U.S. health jurisdictions. We also evaluated the programmatic benefits of combining MIRU24 and spoligotyping with epidemiologic evidence in identifying potential recent TB transmission. We examined 342 TB patients in 42 spoligotype/MIRU12 (PCRType) clusters (equivalent to 46 spoligotype/MIRU24 [GENType] clusters) to identify epidemiologic links among cases. GENType clusters, when compared to PCRType clusters, had 12 times higher odds of epidemiologic links being identified if patients were younger than 25 years and 3 times higher odds if patients resided in the same zip code, or had HIV infection. Sixty (18%) fewer PCRType-clustered patients would need investigations if clusters are defined using GENType instead of PCRType. An important advantage of defining clusters by MIRU24 is resource savings related to the reduced number of clustered cases needing investigation.