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Free Content Genotyping of Mycobacterium tuberculosis over two periods: a changing scenario for tuberculosis transmission

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OBJECTIVE: To evaluate changes in the molecular epidemiology of tuberculosis (TB) in Zaragoza, Spain, over a decade that has seen large social and health changes, including the attenuation of the human immunodeficiency virus (HIV) epidemic and increased immigration.

DESIGN: A population-based molecular study was conducted using standard restriction fragment length polymorphism IS6110 typing that included all patients with bacteriologically confirmed TB living in the Zaragoza area from 2001 to 2004. The current situation was compared with that described in a previous study from 1993 to 1995.

RESULTS: A total of 454 Mycobacterium tuberculosis isolates were genotyped; 239 (52.6%) were grouped in 45 clusters composed of 2 to 85 isolates. Independent risk factors for clustering were identified. The main differences with the previous study were the increase of TB cases among immigrants, a decrease in HIV-TB co-infected patients and the occurrence of a large TB outbreak involving 85 patients (M. tuberculosis Zaragoza [MTZ] strain).

CONCLUSION: A change in the epidemiological pattern of TB has been observed in the last years. TB transmission is more common among the Spanish-born population, while foreign birth is significantly less associated with clustering. A single epidemic strain caused 18.7% of all TB cases.
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Keywords: IS6110 RFLP; molecular epidemiology; tuberculosis; tuberculosis transmission

Document Type: Regular Paper

Affiliations: 1: Servicio de Microbiología, Hospital Universitario Miguel Servet, Zaragoza, Spain; and Centro de Investigación Biomédica en Red, Enfermedades Respiratorias, Recinto Hospital Joan March, Mallorca, Spain 2: Centro de Investigación Biomédica en Red, Enfermedades Respiratorias, Recinto Hospital Joan March, Mallorca, Spain; and Servicio de Microbiología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain

Publication date: 01 October 2007

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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