Skip to main content
PMC home page
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1995 Aug;33(8):2077–2081. doi: 10.1128/jcm.33.8.2077-2081.1995

Molecular epidemiology of tuberculosis in Denmark in 1992.

Z H Yang 1, P E de Haas 1, C H Wachmann 1, D van Soolingen 1, J D van Embden 1, A B Andersen 1
PMCID: PMC228338  PMID: 7559951

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.(ABSTRACT TRUNCATED AT 250 WORDS)

Full Text

The Full Text of this article is available as a PDF (248.6 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alland D., Kalkut G. E., Moss A. R., McAdam R. A., Hahn J. A., Bosworth W., Drucker E., Bloom B. R. Transmission of tuberculosis in New York City. An analysis by DNA fingerprinting and conventional epidemiologic methods. N Engl J Med. 1994 Jun 16;330(24):1710–1716. doi: 10.1056/NEJM199406163302403. [DOI] [PubMed] [Google Scholar]
  2. Barnes P. F., Bloch A. B., Davidson P. T., Snider D. E., Jr Tuberculosis in patients with human immunodeficiency virus infection. N Engl J Med. 1991 Jun 6;324(23):1644–1650. doi: 10.1056/NEJM199106063242307. [DOI] [PubMed] [Google Scholar]
  3. Brudney K., Dobkin J. Resurgent tuberculosis in New York City. Human immunodeficiency virus, homelessness, and the decline of tuberculosis control programs. Am Rev Respir Dis. 1991 Oct;144(4):745–749. doi: 10.1164/ajrccm/144.4.745. [DOI] [PubMed] [Google Scholar]
  4. Collins C. H., Yates M. D., Grange J. M. Subdivision of Mycobacterium tuberculosis into five variants for epidemiological purposes: methods and nomenclature. J Hyg (Lond) 1982 Oct;89(2):235–242. doi: 10.1017/s0022172400070765. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dooley S. W., Jarvis W. R., Martone W. J., Snider D. E., Jr Multidrug-resistant tuberculosis. Ann Intern Med. 1992 Aug 1;117(3):257–259. doi: 10.7326/0003-4819-117-3-257. [DOI] [PubMed] [Google Scholar]
  6. Goble M., Iseman M. D., Madsen L. A., Waite D., Ackerson L., Horsburgh C. R., Jr Treatment of 171 patients with pulmonary tuberculosis resistant to isoniazid and rifampin. N Engl J Med. 1993 Feb 25;328(8):527–532. doi: 10.1056/NEJM199302253280802. [DOI] [PubMed] [Google Scholar]
  7. Godfrey-Faussett P., Mortimer P. R., Jenkins P. A., Stoker N. G. Evidence of transmission of tuberculosis by DNA fingerprinting. BMJ. 1992 Jul 25;305(6847):221–223. doi: 10.1136/bmj.305.6847.221. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hermans P. W., van Soolingen D., Bik E. M., de Haas P. E., Dale J. W., van Embden J. D. Insertion element IS987 from Mycobacterium bovis BCG is located in a hot-spot integration region for insertion elements in Mycobacterium tuberculosis complex strains. Infect Immun. 1991 Aug;59(8):2695–2705. doi: 10.1128/iai.59.8.2695-2705.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Raviglione M. C., Sudre P., Rieder H. L., Spinaci S., Kochi A. Secular trends of tuberculosis in western Europe. Bull World Health Organ. 1993;71(3-4):297–306. [PMC free article] [PubMed] [Google Scholar]
  10. Small P. M., Hopewell P. C., Singh S. P., Paz A., Parsonnet J., Ruston D. C., Schecter G. F., Daley C. L., Schoolnik G. K. The epidemiology of tuberculosis in San Francisco. A population-based study using conventional and molecular methods. N Engl J Med. 1994 Jun 16;330(24):1703–1709. doi: 10.1056/NEJM199406163302402. [DOI] [PubMed] [Google Scholar]
  11. Yang Z. H., Mtoni I., Chonde M., Mwasekaga M., Fuursted K., Askgård D. S., Bennedsen J., de Haas P. E., van Soolingen D., van Embden J. D. DNA fingerprinting and phenotyping of Mycobacterium tuberculosis isolates from human immunodeficiency virus (HIV)-seropositive and HIV-seronegative patients in Tanzania. J Clin Microbiol. 1995 May;33(5):1064–1069. doi: 10.1128/jcm.33.5.1064-1069.1995. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Yang Z. H., de Haas P. E., van Soolingen D., van Embden J. D., Andersen A. B. Restriction fragment length polymorphism Mycobacterium tuberculosis strains isolated from Greenland during 1992: evidence of tuberculosis transmission between Greenland and Denmark. J Clin Microbiol. 1994 Dec;32(12):3018–3025. doi: 10.1128/jcm.32.12.3018-3025.1994. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Yuen L. K., Ross B. C., Jackson K. M., Dwyer B. Characterization of Mycobacterium tuberculosis strains from Vietnamese patients by Southern blot hybridization. J Clin Microbiol. 1993 Jun;31(6):1615–1618. doi: 10.1128/jcm.31.6.1615-1618.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. van Embden J. D., Cave M. D., Crawford J. T., Dale J. W., Eisenach K. D., Gicquel B., Hermans P., Martin C., McAdam R., Shinnick T. M. Strain identification of Mycobacterium tuberculosis by DNA fingerprinting: recommendations for a standardized methodology. J Clin Microbiol. 1993 Feb;31(2):406–409. doi: 10.1128/jcm.31.2.406-409.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. van Embden J. D., van Soolingen D., Small P. M., Hermans P. W. Genetic markers for the epidemiology of tuberculosis. Res Microbiol. 1992 May;143(4):385–391. doi: 10.1016/0923-2508(92)90051-o. [DOI] [PubMed] [Google Scholar]
  16. van Soolingen D., Hermans P. W., de Haas P. E., Soll D. R., van Embden J. D. Occurrence and stability of insertion sequences in Mycobacterium tuberculosis complex strains: evaluation of an insertion sequence-dependent DNA polymorphism as a tool in the epidemiology of tuberculosis. J Clin Microbiol. 1991 Nov;29(11):2578–2586. doi: 10.1128/jcm.29.11.2578-2586.1991. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. van Soolingen D., de Haas P. E., Hermans P. W., Groenen P. M., van Embden J. D. Comparison of various repetitive DNA elements as genetic markers for strain differentiation and epidemiology of Mycobacterium tuberculosis. J Clin Microbiol. 1993 Aug;31(8):1987–1995. doi: 10.1128/jcm.31.8.1987-1995.1993. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. van Soolingen D., de Haas P. E., Hermans P. W., van Embden J. D. DNA fingerprinting of Mycobacterium tuberculosis. Methods Enzymol. 1994;235:196–205. doi: 10.1016/0076-6879(94)35141-4. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES