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Tuberculosis Epidemiologic Studies Consortium (TBESC)
Task Order 8: An analysis of molecular epidemiology of
multi-drug resistant M. tuberculosis in the United States
The purpose of the Task Order 8 research project is to develop a
comprehensive national tuberculosis (TB) genotyping registry for TB
case-patients with multidrug-resistant M. tuberculosis (MDR-TB
)
and to assess the molecular epidemiology of MDR-TB
in the United
States (U.S.). It is anticipated that this ongoing surveillance of
MDR-TB
cases through collection of genotyping data and epidemiologic
investigations will help clarify the dynamics of MDR-TB
transmission, factors contributing to spread, and identify and
evaluate potential areas for appropriate interventions.
Sites
American Lung Association of Metropolitan Chicago, California
Department of Health Services, Denver Health and Hospital, Emory
University (Atlanta, GA), Maryland Department of Health,
Massachusetts Department of Health, New York City Department of
Health, New York State Department of Health, Seattle-King County
Department of Public Health, Tennessee Department of Health, Texas
Department of State Health Services, University of Medicine and
Dentistry, and University of North Texas Health Science Center at
Fort Worth.
Study Objectives
- To determine the frequency and the contribution of factors
responsible for MDR-TB transmission in the U.S.;
- To describe the factors related to transmission of MDR-TB
within the U.S.;
- To assess factors related to the preventability of MDR-TB
(transmitted, acquired and imported MDR-TB) within the U.S.
Study Design
This project will be a 3-year cross-sectional population based
study design where the recruitment and data collection are handled
prospectively. It will include a large representation of MDR-TB
cases located in 14 U.S. sites selected from the TBESC consortium.
Cluster investigations will be completed for both MDR-TB
and non MDR-TB
cases who have a matching genotype to a MDR-TB
case, who are named
as a contact (in Public Health records) or found on a contact roster
of a MDR-TB
and are Isoniazid or Rifampin mono-resistant. Clinical
culture negative pediatric TB cases (under age 5) who were
identified as an exposed contact by the MDR-TB
case during the
interview or were already listed as a contact to a MDR-TB
case by
the public health department will also be a part of the cluster
investigations. Genotyping will be completed for isolates submitted
for MDR-TB
and non MDR-TB
cases. For this study, isolates from MDR-TB
cases in the U.S. will be sent to two regional DNA genotyping
laboratories for both spoligotyping and MIRU genotyping followed by
IS6110-based RFLP analysis as part of the CDC Universal Genotyping
program. In addition to spoligotyping and MIRU typing for all cases,
IS6110-based RFLP typing will be completed for all MDR-TB
and non
MDR-TB
cases clustered with MDR-TB
cases in order to further
differentiate between TB strains and identify clusters.
Study Progress
Piloting was conducted in five sites and the pilot data led to
significant changes to the protocol, questionnaire and data
abstraction forms. Questionnaires and consent forms have been
translated in Tagalog, Chinese, Spanish, Vietnamese and Hindi.
Official enrollment began at some sites in April 2007 and there are
still some sites that are waiting for final IRB approval.
Last Modified: 07/25/2007
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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