Overlapping prison/community tuberculosis outbreaks in Costa Rica revealed by alternative analysis of suboptimal material
Por:
Jbara S, Herranz M, Sola-Campoy PJ, Rodríguez-Grande C, Chiner-Oms Á, Comas I, Muñoz P, García de Viedma D and Pérez-Lago L
Publicada:
1 may 2022
Ahead of Print:
1 mar 2021
Resumen:
Costa Rica has a low incidence of tuberculosis. Thus, identifying transmission hotspots is key to implement interventions. A tuberculosis outbreak was suspected in a prison in Costa Rica. Given the suboptimal quality of the samples received in our laboratory in Madrid, we applied alternative schemes for their analysis. In the first scheme, we bypassed the standard approach of applying systematic mycobacterial interspersed repetitive units-variable number of tandem repeats (MIRU-VNTR) and used a strain-specific polymerase chain reaction (PCR) that allowed identifying a cluster involving six cases (C1). The second scheme followed the canonical MIRU-VNTR path coupled with a whole-genomic amplification step, by which a second unsuspected overlapping cluster (C2), was detected in the same prison. These findings justified the implementation of a surveillance programme adapted to local resources based on a tailored multiplex allele-specific oligonucleotide (ASO)-PCR targeting C1 and C2. Presence of the C2 strain at a different prison was determined. ASO-PCR was applied extensively and alerted to the active circulation of one of the strains within and beyond prisons. Our study shows that alternative methodological strategies may provide useful data in settings with lack of resources for performing systematic standard molecular epidemiology programmes and/or with suboptimal material for analysis.
Filiaciones:
Jbara S:
Centro Nacional de Referencia de Micobacteriología, Tres Ríos, Costa Rica
Herranz M:
Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
CIBER Enfermedades Respiratorias, CIBERES, Spain
Sola-Campoy PJ:
Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
Rodríguez-Grande C:
Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
:
Unidad Mixta Genómica y Salud, Centro Superior de Investigación en Salud Pública (FISABIO), Universitat de València, Valencia, Spain
:
Instituto de Biomedicina de Valencia (IBV-CSIC), Valencia, Spain
CIBER en Epidemiología y Salud Pública (CIBERESP), Spain
Muñoz P:
Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
CIBER Enfermedades Respiratorias, CIBERES, Spain
Department of Medicine, Universidad Complutense de Madrid, Spain
García de Viedma D:
Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
CIBER Enfermedades Respiratorias, CIBERES, Spain
Pérez-Lago L:
Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
gold
|