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Molecular epidemiology of tuberculosis in Denmark in 1992.

https://arctichealth.org/en/permalink/ahliterature35231
Source
J Clin Microbiol. 1995 Aug;33(8):2077-81
Publication Type
Article
Date
Aug-1995
Author
Z H Yang
P E de Haas
C H Wachmann
D. van Soolingen
J D van Embden
A B Andersen
Author Affiliation
Mycobacteria Department, Statens Seruminstitut, Copenhagen, Denmark.
Source
J Clin Microbiol. 1995 Aug;33(8):2077-81
Date
Aug-1995
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
DNA Fingerprinting
Denmark - epidemiology
Emigration and Immigration
Epidemiology, Molecular
Female
Humans
Infant
Infant, Newborn
Male
Middle Aged
Mycobacterium tuberculosis - genetics - isolation & purification
Polymorphism, Restriction Fragment Length
Research Support, Non-U.S. Gov't
Risk factors
Tuberculosis, Pulmonary - epidemiology - microbiology - transmission
Abstract
The incidence of tuberculosis (TB) is increasing all over the world, including in countries with a high standard of living and good social security. Denmark represents such a region. Furthermore, it is a small country (5 million inhabitants) with a long tradition in TB control, including a centralization of the bacteriological diagnostic facility. The present study was intended to analyze the transmission of Mycobacterium tuberculosis in a country in which TB has low endemicity by a combination of conventional epidemiological approaches and DNA fingerprinting techniques, whereby individual bacterial strains can be traced. M. tuberculosis isolates from 92% of all new cases of bacteriologically verified TB in Denmark during 1992 were subjected to IS6110 DNA fingerprinting to visualize the DNA restriction fragment length polymorphism (RFLP) patterns of the isolated strains. The data obtained from the RFLP analyses were interpreted by using demographic data, such as age, sex, ethnicity, and residence, for the patients. The risk factors among the patients for being part of an active chain of transmission, as opposed to demonstrating reactivation of a previously acquired latent infection, were estimated by statistical analyses. The magnitude of TB transmission in 1992 in Denmark was determined, and transmitted infections were shown to comprise at least one quarter of the total number of cases. Almost half of the TB cases involved patients of foreign origin. However, most of these isolates showed unique DNA fingerprint patterns and were rarely part of an active chain of transmission. The major chains of recent transmission were localized to distinct geographical regions in the country. TB is frequent among immigrants, especially from Asia and Africa, but it is apparently readily suspected, diagnosed, and treated by the health care system. Danish patients with pulmonary symptoms are not primarily suspected to have TB and, therefore, play an important role in recent TB transmission in Denmark.
PubMed ID
7559951 View in PubMed
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Restriction fragment length polymorphism Mycobacterium tuberculosis strains isolated from Greenland during 1992: evidence of tuberculosis transmission between Greenland and Denmark.

https://arctichealth.org/en/permalink/ahliterature69581
Source
J Clin Microbiol. 1994 Dec;32(12):3018-25
Publication Type
Article
Date
Dec-1994
Author
Z H Yang
P E de Haas
D. van Soolingen
J D van Embden
A B Andersen
Author Affiliation
Mycobacteria Department, Statens Seruminstitut, Copenhagen, Denmark.
Source
J Clin Microbiol. 1994 Dec;32(12):3018-25
Date
Dec-1994
Language
English
Publication Type
Article
Keywords
Cross-Sectional Studies
DNA Fingerprinting
DNA, Bacterial
Denmark - epidemiology
Greenland - epidemiology
Humans
Morbidity
Mycobacterium tuberculosis - genetics - isolation & purification
Polymorphism, Restriction Fragment Length
Research Support, Non-U.S. Gov't
Tuberculosis, Pulmonary - epidemiology - microbiology - transmission
Abstract
In order to describe the transmission of tuberculosis (TB) at the clonal level in a defined geographic region during a certain period of time, all isolates of Mycobacterium tuberculosis collected during 1992 from Greenland were subjected to analyses of DNA restriction fragment length polymorphism (RFLP). The RFLP patterns obtained by probing the genomic DNA with the repetitive insertion segment IS6110 revealed a high degree of similarity among the isolates, indicating a relatively high transmission rate and a close relationship between the individual M. tuberculosis clones. This was further confirmed by reprobing the Southern blots with two more-stable genetic markers, IS1081 and the DR sequence. The RFLP patterns were compared with those of 245 M. tuberculosis strains collected from Denmark during the same period (representing 91% of all new, bacteriologically verified cases of TB in Denmark in 1992). One of the three prevalent IS6110-defined clusters was traced to a group of immigrants from Greenland living in a small, defined geographical region in Denmark and to a group of Danish citizens either with known contact with these immigrants or, in other cases, with a record of previous travel or working activities in Greenland. The study showed that the present technique is extremely helpful in monitoring the spread of TB and thereby also contributing to improved disease control.
PubMed ID
7883893 View in PubMed
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Risk of Mycobacterium tuberculosis transmission in a low-incidence country due to immigration from high-incidence areas.

https://arctichealth.org/en/permalink/ahliterature69422
Source
J Clin Microbiol. 2001 Mar;39(3):855-61
Publication Type
Article
Date
Mar-2001
Author
T. Lillebaek
A B Andersen
J. Bauer
A. Dirksen
S. Glismann
P. de Haas
A. Kok-Jensen
Author Affiliation
International Reference Laboratory for Mycobacteriology, Statens Serum Institut, National Institute for Prevention and Control of Infectious Diseases and Congenital Disorders, 5 Artillerivej, 2300 Copenhagen S, Denmark. Lillebaek@dadlnet.dk
Source
J Clin Microbiol. 2001 Mar;39(3):855-61
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Cluster analysis
DNA, Intergenic
Denmark - epidemiology
Emigration and Immigration
Female
Humans
Incidence
Male
Middle Aged
Mycobacterium tuberculosis - classification - genetics
Oligonucleotides - analysis
Polymorphism, Restriction Fragment Length
Research Support, Non-U.S. Gov't
Risk factors
Somalia - epidemiology
Tuberculosis, Pulmonary - epidemiology - microbiology - transmission
Abstract
Does immigration from a high-prevalence area contribute to an increased risk of tuberculosis in a low-incidence country? The tuberculosis incidence in Somalia is among the highest ever registered. Due to civil war and starvation, nearly half of all Somalis have been forced from their homes, causing significant migration to low-incidence countries. In Denmark, two-thirds of all tuberculosis patients are immigrants, half from Somalia. To determine the magnitude of Mycobacterium tuberculosis transmission between Somalis and Danes, we analyzed DNA fingerprint patterns of isolates collected in Denmark from 1992 to 1999, comprising >97% of all culture-positive patients (n = 3,320). Of these, 763 were Somalian immigrants, 55.2% of whom shared identical DNA fingerprint patterns; 74.9% of these were most likely infected before their arrival in Denmark, 23.3% were most likely infected in Denmark by other Somalis, and 1.8% were most likely infected by Danes. In the same period, only 0.9% of all Danish tuberculosis patients were most likely infected by Somalis. The Somalian immigrants in Denmark could be distributed into 35 different clusters with possible active transmission, of which 18 were retrieved among Somalis in the Netherlands. This indicated the existence of some internationally predominant Somalian strains causing clustering less likely to represent recent transmission. In conclusion, M. tuberculosis transmission among Somalis in Denmark is limited, and transmission between Somalis and Danes is nearly nonexistent. The higher transmission rates between nationalities found in the Netherlands do not apply to the situation in Denmark and not necessarily elsewhere, since many different factors may influence the magnitude of active transmission.
PubMed ID
11230395 View in PubMed
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Tracing Mycobacterium tuberculosis transmission by whole genome sequencing in a high incidence setting: a retrospective population-based study in East Greenland.

https://arctichealth.org/en/permalink/ahliterature292531
Source
Sci Rep. 2016 09 12; 6:33180
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
09-12-2016
Author
K Bjorn-Mortensen
B Soborg
A Koch
K Ladefoged
M Merker
T Lillebaek
A B Andersen
S Niemann
T A Kohl
Author Affiliation
Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Source
Sci Rep. 2016 09 12; 6:33180
Date
09-12-2016
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Child
Female
Genotype
Greenland - epidemiology
Humans
Incidence
Male
Molecular Typing
Mycobacterium tuberculosis - genetics
Retrospective Studies
Tuberculosis, Pulmonary - epidemiology - microbiology - transmission
Whole Genome Sequencing
Young Adult
Abstract
In East Greenland, a dramatic increase of tuberculosis (TB) incidence has been observed in recent years. Classical genotyping suggests a genetically similar Mycobacterium tuberculosis (Mtb) strain population as cause, however, precise transmission patterns are unclear. We performed whole genome sequencing (WGS) of Mtb isolates from 98% of culture-positive TB cases through 21?years (n?=?182) which revealed four genomic clusters of the Euro-American lineage (mainly sub-lineage 4.8 (n?=?134)). The time to the most recent common ancestor of lineage 4.8 strains was found to be 100?years. This sub-lineage further diversified in the 1970s, and massively expanded in the 1990s, a period of lowered TB awareness in Greenland. Despite the low genetic strain diversity, WGS data revealed several recent short-term transmission events in line with the increasing incidence in the region. Thus, the isolated setting and the uniformity of circulating Mtb strains indicated that the majority of East Greenlandic TB cases originated from one or few strains introduced within the last century. Thereby, the study shows the consequences of even short interruptions in TB control efforts in previously TB high incidence areas and demonstrates the potential role of WGS in detecting ongoing micro epidemics, thus guiding public health efforts in the future.
Notes
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PubMed ID
27615360 View in PubMed
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