Spatiotemporal Clustering of Mycobacterium tuberculosis Complex Genotypes in Florida: Genetic Diversity Segregated by Country of Birth.
Spatiotemporal Clustering of Mycobacterium tuberculosis Complex Genotypes in Florida: Genetic Diversity Segregated by Country of Birth.
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DOI：
10.1371/journal.pone.0153575
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Blackburn JK
中科院分区：
文献类型：
--
作者：
Séraphin MN;Lauzardo M;Doggett RT;Zabala J;Morris JG Jr;Blackburn JK
结核病（TB）是由结核分枝杆菌复合体（MTBC）的成员引起的。虽然MTBC是高度克隆的，但已观察到菌株间的遗传多样性。在结核病发病率低的环境中，移民可能会促进结核分枝杆菌菌株的进口，从而使结核病控制工作复杂化。我们调查了2009年至2013年期间在美国佛罗里达分离的2，510株MTBC菌株的遗传多样性和时空聚类，并使用spoligotyping和24位点MIRU-VNTR进行基因分型。我们利用地理信息系统（GIS）将遗传多样性映射到患者住宅邮政编码的质心。我们评估了传播动力学和移民对基因型聚类的影响，使用时空排列模型调整外国出生的人口密度和县级艾滋病毒风险和多项模型分层的出生国和移民的时间在SaTScan。在2，510个菌株中，1，245个在外国出生的人中报告;包括408个最近的移民（<5年）。菌株等位基因多样性（h）范围从低到中，在大多数地方，是最多样化的城市中心，外国出生的人口密度也很高。总体而言，美国21.5%的病例出生的人和4.6%的外国出生的人聚集的基因型和时空和涉及菌株的哈勒姆家庭。在佛罗里达的大部分农村北方地区确定的一个哈勒姆时空集群包括在诊断时被监禁的美国/加拿大出生的个人;在佛罗里达的大部分城市南部地区的两个集群主要由外国出生的人组成。这两个群体的艾滋病毒感染率都超过20%。2009年至2013年期间，佛罗里达报告的结核病病例中，近5%可能是由于最近的传播造成的。在监狱人口和新移民中改进结核病筛查做法可能会影响结核病控制。由于可用标记的单态性，需要全基因组测序来最终描绘美国和外国出生的人之间的最近传播事件。
Tuberculosis (TB) is caused by members of the Mycobacterium tuberculosis complex (MTBC). Although the MTBC is highly clonal, between-strain genetic diversity has been observed. In low TB incidence settings, immigration may facilitate the importation of MTBC strains with a potential to complicate TB control efforts. We investigated the genetic diversity and spatiotemporal clustering of 2,510 MTBC strains isolated in Florida, United States, between 2009 and 2013 and genotyped using spoligotyping and 24-locus MIRU-VNTR. We mapped the genetic diversity to the centroid of patient residential zip codes using a geographic information system (GIS). We assessed transmission dynamics and the influence of immigration on genotype clustering using space-time permutation models adjusted for foreign-born population density and county-level HIV risk and multinomial models stratified by country of birth and timing of immigration in SaTScan. Among the 2,510 strains, 1,245 were reported among foreign-born persons; including 408 recent immigrants (<5 years). Strain allelic diversity (h) ranged from low to medium in most locations and was most diverse in urban centers where foreign-born population density was also high. Overall, 21.5% of cases among U.S.-born persons and 4.6% among foreign-born persons clustered genotypically and spatiotemporally and involved strains of the Haarlem family. One Haarlem space-time cluster identified in the mostly rural northern region of Florida included US/Canada-born individuals incarcerated at the time of diagnosis; two clusters in the mostly urban southern region of Florida were composed predominantly of foreign-born persons. Both groups had HIV prevalence above twenty percent. Almost five percent of TB cases reported in Florida during 2009–2013 were potentially due to recent transmission. Improvements to TB screening practices among the prison population and recent immigrants are likely to impact TB control. Due to the monomorphic nature of available markers, whole genome sequencing is needed to conclusively delineate recent transmission events between U.S. and foreign-born persons.