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Terre-de-Bas, Guadeloupe

Jagielski T.,University of Warsaw | Minias A.,Polish Academy of Sciences | van Ingen J.,Radboud University Nijmegen | Rastogi N.,Institute Pasteur Of La Guadeloupe | And 3 more authors.
Clinical Microbiology Reviews | Year: 2016

Molecular typing has revolutionized epidemiological studies of infectious diseases, including those of a mycobacterial etiology. With the advent of fingerprinting techniques, many traditional concepts regarding transmission, infectivity, or pathogenicity of mycobacterial bacilli have been revisited, and their conventional interpretations have been challenged. Since the mid-1990s, when the first typing methods were introduced, a plethora of other modalities have been proposed. So-called molecular epidemiology has become an essential subdiscipline of modern mycobacteriology. It serves as a resource for understanding the key issues in the epidemiology of tuberculosis and other mycobacterial diseases. Among these issues are disclosing sources of infection, quantifying recent transmission, identifying transmission links, discerning reinfection from relapse, tracking the geographic distribution and clonal expansion of specific strains, and exploring the genetic mechanisms underlying specific phenotypic traits, including virulence, organ tropism, transmissibility, or drug resistance. Since genotyping continues to unravel the biology of mycobacteria, it offers enormous promise in the fight against and prevention of the diseases caused by these pathogens. In this review, molecular typing methods for Mycobacterium tuberculosis and nontuberculous mycobacteria elaborated over the last 2 decades are summarized. The relevance of these methods to the epidemiological investigation, diagnosis, evolution, and control of mycobacterial diseases is discussed. © 2016, American Society for Microbiology. All Rights Reserved. Source

Marais E.,University of Witwatersrand | Mlambo C.K.,University of Witwatersrand | Lewis J.J.,London School of Hygiene and Tropical Medicine | Rastogi N.,Institute Pasteur Of La Guadeloupe | And 6 more authors.
Infection | Year: 2014

Purpose: Multidrug-resistant tuberculosis (MDR-TB) is associated with lengthy treatment, expensive and potentially toxic regimens, and high rates of treatment failure and death. This study describes the outcomes of 351 MDR-TB patients who started treatment between 2004 and 2007 at the provincial MDR-TB referral hospital in Johannesburg, South Africa, and investigates risk factors associated with death. Methods: The study involved the assessment of factors associated with treatment outcomes using a retrospective review of patient records, drug-susceptibility data and spoligotyping of isolates. Results: Treatment success (completion/cure) was recorded in 158 (48.8 %) patients, while 65 (20 %) died, 93 (28.7 %) defaulted, 8 (2.5 %) failed treatment, 11(3.1 %) were transferred out to other health facilities and 16 (4.6 %) had no recorded final outcome. The proportion of successful treatment increased significantly over time. Univariable and multivariable analysis (P = 0.05) identified the year of MDR-TB diagnosis and spoligotype-defined families as factors associated with treatment outcome. No associations were found between treatment outcome and human immunodeficiency virus (HIV) status, previous TB and additional MDR resistance to streptomycin or ethambutol. Molecular typing of the strains revealed a diverse group of spoligotypes, with Beijing, LAM4 and H3 making up the largest groups. Conclusions: This is the first published study to investigate treatment outcomes at this facility and to find a link between genotype and treatment outcome, suggesting that genotype determination could potentially serve as a prognostic factor. © 2013 Springer-Verlag. Source

Couvin D.,Institute Pasteur Of La Guadeloupe | Rastogi N.,Institute Pasteur Of La Guadeloupe
Tuberculosis | Year: 2015

We argue in favor of a concerted and coordinated response to stop tuberculosis (TB) by monitoring global TB spread, drug-resistance surveillance and populations at risk using available molecular and web tools to identify circulating clones of Mycobacterium tuberculosis complex (MTBC). We took specific example of the Beijing lineage associated with worldwide emergence of both multiple, and extensively drug resistant (MDR/XDR)-TB. The study dataset (n = 10,850 isolates, 92 countries of patient origin) was extracted from our multimarker SITVIT2 database on MTBC genotyping (n = 111,635 isolates, 169 countries of patient origin). Epidemiological and demographic information in conjunction with spoligotyping (n = 10,850), MIRU-VNTR minisatellites (n = 2896), and drug resistance (n = 2846) data was mapped at macro-geographical (United Nations subregions) and country level, followed by statistical, bioinformatical, and phylogenetical analysis. The global male/female sex ratio was 1.96, the highest being 4.93 in Russia vs. range of 0.8-1.13 observed in Central America, Caribbean, Eastern Africa and Northern Europe (p < 0.0001). The major patient age-group was 21-40 yrs worldwide except Japan (with majority of patients >60 yrs). Younger patients were more common in South America, South Asia, and Western Africa since 25-33% of TB cases due to Beijing genotype occurred in the age group 0-20 yrs. A continuous progression in the proportion of MDR and XDR strains is visible worldwide since 2003 and 2009 respectively. Pansusceptible TB mainly concerned older patients >60 yrs (44%) whereas Drug resistant, MDR and XDR-TB concerned patients preferentially aged 21-40 yrs (between 52 and 58%). Although the proportion of SIT1 pattern vs. other patterns was very high (93%); the proportion of MDR was highest for an emerging genotype SIT190 (p < 0.0001). Lastly, proportion of pansusceptible strains was highest in Japan, while MDR/XDR strains were most common in Russia and Northern Europe. We underline remarkable macro/micro-geographical cleavages in phylogenetic and epidemiologic diversity of Beijing genotype, with phylogeographical specificity of certain genotypes. © 2015 Elsevier Ltd. All rights reserved. Source

Molina-Torres C.A.,Hospital Universitario Jose nzalez | Moreno-Torres E.,Hospital Universitario Jose nzalez | Ocampo-Candiani J.,Hospital Universitario Jose nzalez | Rendon A.,Hospital Universitario Jose nzalez | And 5 more authors.
Journal of Clinical Microbiology | Year: 2010

Although tuberculosis is still a public health problem in Mexico, there is little information about the genetic characteristics of the isolates. In the present study, we analyzed by spoligotyping 180 Mycobacterium tuberculosis clinical isolates from the urban area of Monterrey, Mexico, including drug-susceptible and drug-resistant isolates. The spoligotype patterns were compared with those in the international SITVIT2 spoligotyping database. Four isolates presented spoligotype patterns not found in the database (orphan types); the rest were distributed among 44 spoligo international types (SITs). SIT53 (clade T1) and SIT119 (clade X1) were predominant and included 43 (23.8%) and 28 (15.5%) of the isolates, respectively. In order to determine if there was a dominant spoligotype in the group of multidrug-resistant isolates, 37 of them were analyzed by IS6110-based restriction fragment length polymorphism assays, and scarce clustering of strains with more than five bands was observed. Fourteen isolates of this multidrug-resistant group presented four bands or less and were distributed in four SITs: SIT53 (n = 8), SIT92 (n = 3), SIT70 (n = 2), and SIT3038 (n = 1). When the molecular detection of mutations in the katG and rpoB genes were analyzed in these isolates with low copy numbers of IS6110, only two isolates shared the same IS6110, spoligotyping, and mutations patterns. When the distribution of the spoligotypes was analyzed by age cohort, SIT119 was predominantly found in patients 0 to 20 years old, especially in males, accounting for up to 40% of the isolates. In contrast, SIT53 was more prevalent in older females. This analysis demonstrates the variability of M. tuberculosis isolates in Monterrey and the partial dominance of SIT53 and SIT119 in that area of Mexico. Copyright © 2010, American Society for Microbiology. All Rights Reserved. Source

Cadelis G.,Service Route | Rossigneux E.,Service Route | Millet J.,Institute Pasteur Of La Guadeloupe | Rastogi N.,Institute Pasteur Of La Guadeloupe
Revue des Maladies Respiratoires | Year: 2012

Most of the migrants residing in Guadeloupe are from neighboring Caribbean islands, some of which are characterized by a high incidence of tuberculosis. The objective of this retrospective and observational study was to define the epidemiological characteristics of tuberculosis affecting migrant and native populations in Guadeloupe. Methods.-We describe all cases of tuberculosis in Guadeloupe identified in these two populations between 1 July 2006 and 30 June 2011. Results.-The incidence of TB among migrants in Guadeloupe was seven times higher than that in native subjects in 2010 (33.4 vs. 5.5 new cases/100,000 inhabitants). Tuberculosis affecting the migrant population was characterized by young age of the patients (42 vs. 55 years) and a significant proportion of co-infection by the human immunodeficiency virus (HIV) (47 vs. 14%, P > 0.001). Among the patient population studied, the HIV infection increased the risk of developing severe tuberculosis (adjusted odds ratio: 2.9; 95%CI: 1.2-6.8). Moreover, HIV infection was also a risk factor for death where the infection was not controlled (CD4 count > 200 units per microliter; adj risk ratio: 3.9; 1.2-12.4). Conclusion.-This study shows that the migrant population in Guadeloupe is at increased risk of tuberculosis and should be considered as a priority target for tuberculosis control program. © 2012 SPLF. Source

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