Table 1

Molecular epidemiological studies on the transmission of tuberculosis

StudyTimeSiteDesignStudy groupAvailability/responsePart of a cluster
n method*[n minus 1] method
MDR, multiple drug resistance; ident., identical fingerprint pattern; dev., deviation with respect to the number or size of the IS6110 insertions.
*The n method starts with all (n) patients in a cluster, the [n minus 1] method subtracts an index case from each cluster. The [n minus 1] method therefore appears to be more appropriate for the calculation of the recent or reactivated cases.
†, ††, †††, ††††Indicates studies with identical or partially identical study populations.
‡Whereas IS6110 is the most commonly used probe internationally, pTBN12 can be used as a secondary probe for confirmation or comparison of IS6110 negative strains. Furthermore, the pTBN12 probe (but not IS6110) allows typing of other mycobacteria.
USA studies
Small et al. 1994601991–92San FranciscoIS6110; exclusion <2 bands473 reported patients69%40%31%(+PGRS: 29%, see comment)
Rhee et al. 200035(Martinez, Rhee et al. 2000;30 Borgdorff et al. 200053)†1991–96San FranciscoIS6110 (ident.)+PGRS for <6 bands (Borgdorff et al. 2000: exclusion of isolates with <5 bands)1370 culture-pos. pat.;30: 1361;53: 1359; only including the 944 cases with pulmonary TB)87%(30: 85%;53: 86%)34%(30: 43%;53: 34% for pulmonary TB)25%(53: 24% for pulmonary TB)
Alland et al. 1994;5 Murray & Alland 2002201993Bronx, New YorkIS6110; additional analysis of preparations with <3 bands104 of 130 pat. of a large hospital80% of the hospital pat.; however only 10% of the assumed 1076 TB patients in New York City40%(12 clusters)30%
Sepkowitz et al. 199568††1992–2/94New York CityIS6110 (ident.)201 pat. from 6 hospitals (“TBNetwork”) with known occupational historyca. 2% of the TB cases in NYC43%
Tornieporth et al. 199758††1992–94New York CityIS6110 (ident.)+pTBN12 for <4 bands‡302 pat. from 7 hospitals (“TBNetwork”)47% of the hospital pat.; however only a very low proportion (<<10%) of all cases in NYC31%
Magnani et al. 2001421996–97; Corresponds to “City Cluster” library (4500 patterns)New York CityIS6110 (ident.); no secondary typing‡180 pat. from 8 hospitals (“TBNetwork”)ca. 50% of the hospital pat.; ca. 13% of the cases in NYC54%(2–17 pat.)
McConkey et al. 2002581998–99St Louis, MissouriIS6110 (ident.)+PGRS (<6 bands or deviation ±1)60 pat.97%38%(7 Cluster mit 2–6 Pat.)27%
Geng et al. 2002571990–99North ManhattanIS6110 (ident.)+spoligotyping (<6 bands)546 culture-pos. TB cases from the Columbia Presbyterian Medical Center73.3% of the culture- positive hospital cases48%(51 clusters with average. 5.2 pat.)38.5%
Ellis et al. 200243†††1996–20007 Sentinel Regions: Arkansas, Maryland, Massachusetts, Michigan, New Jersey, Texas (partially), California (partially)IS6110 (ident.)+spoligotyping (< = 6 bands)10,752 reported pat. with culture-pos. TB90.2% of the culture- pos. cases48.1%(1,018 clusters with 2–105 pat.)38.6%
Sharnprapai etal. 200237†††1996–2000MassachusettsIS6110 (ident.)+spoligotyping (<6 bands)983 reported patients95% of the culture- positive cases27.7%(82 clusters with 2–16 pat.)19.3%
Cronin et al. 2002241996–2000MarylandIS6110 (dev. ±1?)+spoligotyping (<6 bands)1172 reported patients99% of the culture- positive cases37.2%(111 clusters with 2–19 pat.)27.7%
Burman et al. 1997151988–94Denver, ColoradoIS6110 +pTBN12 for all isolates189 reported patients59% with inclusion of the culture-negative patients15 clusters19%(31% with exclusive use of the IS6110 technique)
Braden et al. 1997551992–93ArkansasIS6110 (dev. ±1)+pTBN12235 reported pat. with both types67%33%(24 clusters with 2–7 pat.)23%
Dobbs et al. 2001261994–98AlabamaIS6110 +spoligotyping for < = 5 bands (poss. Also other analyses)253 reported 80%47%(119 clusters)
Hernández-Garduño et al. 2002291995–99Greater VancouverIS6110 (ident.)+spoligotyping (<6 bands)793 reported pat.100%17.3%(46 clusters)11.5%
Kulaga et al. 2002411997–98MontrealIS6110 (dev. ±1/ident.), exclusion <5 bands243 reported pat.80%24.7%(dev. ±1)/7.0%(ident.)18.1%/4.1%
European studies
van Soolingen et al. 199949††††1993–97NetherlandsIS6110 (ident.)+PGRS for <5 bands4,266 pat. (pulmonary+extrapulmonary)78%46%(479 clusters with 2–47 pat.; 52% of the pat. in clusters with ⩽5 pat.)35%
Borgdorff et al. 200146††††1993–98NetherlandsIS6110 (ident.)+PGRS for <5bands3,479 pat. with pulmonary TB (register-based)ca. 83%45%(390 clusters)34%
Diel et al. 2002471997–99HamburgIS6110, exclusion <5 bands423 reported (one of the 8 health offices) patients with TB confirmed by culture77%; after exclusion of isolates with <5 bands 398 included in cluster analysis33.9%(35 clusters with 2–23 pat.)
Niemann et al. 1997331995GermanyIS6110; exclusion ⩽4 bands (n = 4)156 pat. with drug.-resistant TB (after exclusion of 7 pot. cross-contamin. isolatesca. 32%(estimate)29%18%
Genewein et al. 1993281991–92Canton Berne (Switzerland)IS6110 (ident.?); evidently no ident. isolates with low band number163 TB pat. of Canton Berne61% of the culture- pos. cases27.6%(9 clusters with 2–22 pat.)22.1%
Pfyffer et al. 1998341991–93ZurichIS6110 (ident.);+PGRS for <6 bands or minimal deviations361 culture-positive pat.90%17.5%(25 clusters with 2–6 pat.)10.5%
Bauer et al. 1998;37(Yang et al. 199561)1992–96DenmarkIS6110 (ident.); exclusion <5 bands (9%; not with Yang et al. 1995)1549 TB cases (only 1992: 245 pat. [Yang et al. 1995])ca. 84% of the culture-TB pat. (with exclusion of isolates <5 bands)49%(only 1992: 31%[Yang et al. 1995])Not calculable
Bauer et al. 2000234–11/1998Denmark (TB departments in Copenhagen and Jutland)IS6110 (ident.)+spoligotyping with <5 bands163 pat. from 5 TB dept. in Copenhagen and Jutland49.5%63%
Lillebaek et al. 2001451992–99DenmarkIS6110 +spoligotyping763 TB cases in Somali immigrants; 1996–98: 391 cases in Somali immigrants, 470 cases in Danes>97%Somali immigrants: 59.1%(additional spoligotyping: 55.2%)
Heldal et al. 200041994–97NorwayIS6110 (ident.); band number for all isolates > = 551 for the year 1995 reported TB pat.; cluster membership compared with 555 TB pat. 1994–9785% of the culture- pos. TB cases15.7%(6 clusters with 2–6 pers.)
Hayward et al. 2002621993London (Inner)spoligotyping+HIPCR (IS6110-based)552 TB cases80% of the reported culture-pos. TB cases (corr. 56% of all reported cases)27%(42 clusters with 2–15 pat.)19%
Maguire et al. 2002487/1995–1997(Greater) LondonIS6110 (ident.); exclusions:<5 bands (n = 448)2.042 TB cases (diagnosed in one of 54 laboratories) with detection of ⩾5 bands63% of the culture- pos. TB cases (assuming in all 3260 [?, text unclear] culture-pos. TB cases)22.7%(169 clusters with 2–12 persons)14.4%
Vachée et al. 1999391995France (North Department)IS6110 (dev. ±1)154 pat., diagnosed in 38 laboratories66%(comparison with regional survey)18%(14 clusters)9%
Gutiérrez et al. 1998521995Paris and surroundingsIS6110 +DR sequences, exclusion: 1 band (n = 10)272 hospital-based TB cases35.7%(26 clusters with 2–12 pat.)
Codecasa et al. 1999251993–96Milan CityIS6110 (ident.?)+spoligotyping for <3 bands247 of the pat. reported to the TB Reference Center for Lombardy (Villa Marelli Institute)9%(247 of 2616 TB cases); however the degree of completeness for the time window (not given) may be higher30.5% for immigrants, 53% for patients born in Italy
Moro et al. 2002311995–97Milan CityIS 6110+spoligotyping for <5 bands or dev. ±1581 culture-pos. pat., reported by Public Health offices and labs71%41.1%(76 clusters with 2–11 pat.)28.1%
Nastasi u. Mammina 1999321994–98Palermo (Sicily)IS6110 (ident.)95 in-patients in 5 hospitals in Palermo35% of the reported (culture-pos. and negative) pat.12.6%(6 clusters with 2–4 pat.)6.3%
Garzelli et al. 1997401993–95Pisa (Region)IS6110 (ident.)60 pathogen strains in 3 hospitalsHospital15%(4 clusters with 2–3 pat.)8%
Safi et al. 1997361993–95Seville, SpainIS6110 (dev. ±1)175 culture-pos. TB pat. from the University Hospital (176 isolates and 1 reinfection)85%38%(19 clusters with 2–7 pat.)27%
Samper et al. 1998591993Saragossa Region, SpainIS6110 (ident.), exclusion <5 bands22683%39%(28 clusters with 2–10 pat.)27%
Martínez, Sanchez et al. 2000;50 Fernandez de la Hoz et al. 2001271997–98South. MadridIS6110 (ident.)+spoligotyping (<6 bands)148 register-based TB cases71.5% of all pat. with TB42%(18 clusters with 2–12 pat.)30%
Elizaga et al. 2002561995–99Segovia (Spain, rural region)IS6110+spoligotyping87 TB cases diagnosed in the only microbiology lab27.6%(8 clusters with 2–6 pat.)18.4%