RT Journal Article
T1 Urgent Implementation in a Hospital Setting of a Strategy To Rule Out Secondary Cases Caused by Imported Extensively Drug-Resistant Mycobacterium tuberculosis Strains at Diagnosis
A1 Perez-Lago, Laura
A1 Martinez-Lirola, Miguel
A1 Garcia, Sergio
A1 Herranz, Marta
A1 Mokrousov, Igor
A1 Comas, Inaki
A1 Martinez-Priego, Llucia
A1 Bouza, Emilio
A1 Garcia-de-Viedma, Dario
K1 Multiplex pcr assay
K1 Origin
K1 Clone
K1 Coexpansion
K1 Population
K1 B0/w148
K1 Spread
AB Current migratory movements require new strategies for rapidly tracking the transmission of high-risk imported Mycobacterium tuberculosis strains. Whole-genome sequencing (WGS) enables us to identify single-nucleotide polymorphisms (SNPs) and therefore design PCRs to track specific relevant strains. However, fast implementation of these strategies in the hospital setting is difficult because professionals working in diagnostics, molecular epidemiology, and genomics are generally at separate institutions. In this study, we describe the urgent implementation of a system that integrates genomics and molecular tools in a genuine high-risk epidemiological alert involving 2 independent importations of extensively drug resistant (XDR) and pre-XDR Beijing M. tuberculosis strains from Russia into Spain. Both cases involved commercial sex workers with long-standing tuberculosis (TB). The system was based on strain-specific PCRs tailored from WGS data that were transferred to the local node that was managing the epidemiological alert. The optimized tests were available for prospective implementation in the local node 33 working days after receiving the primary cultures of the XDR strains and were applied to all 42 new incident cases. An interpretable result was obtained in each case (directly from sputum for 27 stain-positive cases) and corresponded to the amplification profiles for strains other than the targeted pre-XDR and XDR strains, which made it possible to prospectively rule out transmission of these high-risk strains at diagnosis.
PB Amer soc microbiology
SN 0095-1137
YR 2016
FD 2016-12-01
LK http://hdl.handle.net/10668/19025
UL http://hdl.handle.net/10668/19025
LA en
DS RISalud
RD Apr 18, 2025