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Abstract
DNA fingerprinting of Mycobacterium tuberculosis—a relatively new laboratory technique—offers promise as a powerful aid in the prevention and control of tuberculosis (TB). Established in 1996 by the Centers for Disease Control and Prevention (CDC), the National Tuberculosis Genotyping Surveillance Network was a 5-year prospective, population-based study of DNA fingerprinting conducted from 1996 to 2000. The data from this study suggest multiple molecular epidemiologic and program management uses for DNA fingerprinting in TB public health practice. From these data, we also gain a clearer understanding of the overall diversity of M. tuberculosis strains as well as the presence of endemic strains in the United States. We summarize the key findings and the impact that DNA fingerprinting may have on future approaches to TB control. Although challenges and limitations to the use of DNA fingerprinting exist, the widespread implementation of the technique into routine TB prevention and control practices appears scientifically justified.
Highlights
DNA fingerprinting of Mycobacterium tuberculosis—a relatively new laboratory technique—offers promise as a powerful aid in the prevention and control of tuberculosis (TB)
We address two important implications for DNA fingerprinting of M. tuberculosis: its varied utility as a tool in TB prevention and control and its value in the measurement of the overall diversity of M. tuberculosis strain patterns in the United States, including differences by region and population and the prevalence of endemic strains
DNA fingerprinting of M. tuberculosis has been shown to identify and confirm laboratory cross-contamination or mislabeling
Summary
DNA Fingerprinting of Mycobacterium tuberculosis: Lessons Learned and Implications for the Future. Most findings represented in this issue of Emerging Infectious Diseases come from this study In this synopsis, we address two important implications for DNA fingerprinting of M. tuberculosis: its varied utility as a tool in TB prevention and control and its value in the measurement of the overall diversity of M. tuberculosis strain patterns in the United States, including differences by region and population and the prevalence of endemic strains. Ellis et al [18] show that, despite a decrease in TB incidence rates at all genotyping surveillance network sites, the proportion of cases in clusters stabilized at a relatively high level (~48%) They suggest that this high proportion of clustering may be due to the inclusion of many low-incidence, stable populations in which persons in chains of transmission from past decades still reside in proximity [42]. Might reflect more effective TB control in limiting ongoing transmission, is provocative and merits further investigation
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