scholarly journals Universal Genotyping for Tuberculosis Prevention Programs: a 5-Year Comparison with On-Request Genotyping

2018 ◽  
Vol 56 (5) ◽  
Author(s):  
Jennifer L. Guthrie ◽  
Clare Kong ◽  
David Roth ◽  
Danielle Jorgensen ◽  
Mabel Rodrigues ◽  
...  
Keyword(s):  
Public Health ◽  
Variable Number Tandem Repeat ◽  
Prevention Programs ◽  
Variable Number ◽  
Public Health Professionals ◽  
Tuberculosis Prevention ◽  
Genotype Cluster ◽  
Low Incidence ◽  
Competing Priorities ◽  
Epidemiological Characteristics

ABSTRACTProspective universal genotyping of tuberculosis (TB) isolates is used by many laboratories to detect clusters of cases and inform contact investigations. Prior to universal genotyping, most TB prevention programs genotyped isolates on request only, relying on requests from public health professionals whose knowledge of a patient's clinical, demographic, and epidemiological characteristics suggested potential transmission. To justify the switch from on-request to universal genotyping—particularly in the public health domain, with its limited resources and competing priorities—it is important to demonstrate the additional benefit provided by a universal genotyping program. We compared the clustering patterns revealed by retrospective 24-locus mycobacterial interspersed repetitive unit–variable-number tandem repeat genotyping of all culture-positive isolates over a 5-year period to the patterns previously established by our genotyping-on-request program in the low-incidence setting of British Columbia, Canada. We found that 23.8% of isolates were requested during the study period, and while requested isolates had increased odds of belonging to a genotype cluster (adjusted odds ratio, 2.3; 95% confidence interval, 1.5 to 3.3), only 54.6% clustered with the requested comparator strain. Universal genotyping revealed 94 clusters ranging in size from 2 to 53 isolates (mean = 5) and involving 432 individuals. On-request genotyping missed 54 (57.4%) of these clusters and 130 (30.1%) clustered individuals. Our results underscore that TB patient networks are complex, with unrecognized linkages between patients, and a prospective province-wide universal genotyping program provides an informative, bias-free tool to explore transmission to a degree not possible with on-request genotyping.

scholarly journals Evaluation of molecular typing of foodborne pathogens in European reference laboratories from 2012 to 2013

2016 ◽  
Vol 21 (50) ◽  
Author(s):  
Susanne Schjørring ◽  
Taina Niskanen ◽  
Mia Torpdahl ◽  
Jonas T Björkman ◽  
Eva Møller Nielsen
Keyword(s):  
Public Health ◽  
Foodborne Pathogens ◽  
Molecular Typing ◽  
Variable Number Tandem Repeat ◽  
Health Sector ◽  
Variable Number ◽  
Food Borne Pathogens ◽  
Food Borne ◽  
National Public Health ◽  
Eqa Schemes

In 2012, the European Centre for Disease Prevention and Control (ECDC) initiated external quality assessment (EQA) schemes for molecular typing including the National Public Health Reference Laboratories in Europe. The overall aim for these EQA schemes was to enhance the European surveillance of food-borne pathogens by evaluating and improving the quality and comparability of molecular typing. The EQAs were organised by Statens Serum Institut (SSI) and included Salmonella enterica subsp. enterica, verocytotoxin-producing Escherichia coli (VTEC) and Listeria monocytogenes. Inter-laboratory comparable pulsed-field gel electrophoresis (PFGE) images were obtained from 10 of 17 of the participating laboratories for Listeria, 15 of 25 for Salmonella, but only nine of 20 for VTEC. Most problems were related to PFGE running conditions and/or incorrect use of image acquisition. Analysis of the gels was done in good accordance with the provided guidelines. Furthermore, we assessed the multilocus variable-number tandem repeat analysis (MLVA) scheme for S. Typhimurium. Of 15 laboratories, nine submitted correct results for all analysed strains, and four had difficulties with one strain only. In conclusion, both PFGE and MLVA are prone to variation in quality, and there is therefore a continuous need for standardisation and validation of laboratory performance for molecular typing methods of food-borne pathogens in the human public health sector.

scholarly journals A Suggested Diagnostic Approach for Sporadic Anthrax in Cattle to Protect Public Health

2021 ◽  
Vol 9 (8) ◽  
pp. 1567
Author(s):  
Jana Avberšek ◽  
Jasna Mićunović ◽  
Vasilij Cociancich ◽  
Tomislav Paller ◽  
Darja Kušar ◽  
...  
Keyword(s):  
Public Health ◽  
Real Time ◽  
Real Time Pcr ◽  
Variable Number Tandem Repeat ◽  
Variable Number ◽  
Common Source ◽  
Molecular Testing ◽  
Tissue Samples ◽  
Source Of Infection ◽  
Bacillus Anthracis Spores

The repeated occurrence of anthrax in grazing animals should be a reminder of a widespread presence of Bacillus anthracis spores in the environment. Its rapid diagnosis is critical to protect public health. Here, we report a case of anthrax in cattle that was investigated using conventional and molecular methods. In 2015, six cows suddenly died within three days and the number of dead animals increased to a total of 12 within two weeks. At necropsy, anthrax was suspected. Therefore, spleen tissue samples were collected (from 6/12 animals) and laboratory tests (microscopy, cultivation, and real-time PCR) performed. The results of tissue staining for microscopy and cultivation were in congruence, while B. anthracis real-time PCR outperformed both. Spleen tissues from all six animals were real-time PCR-positive, while B. anthracis was successfully cultivated and detected by microscopy from the spleen of only three animals. Additionally, the ear tissue from another (1/12) cow tested positive by real-time PCR, supporting the suitability of ear clippings for molecular confirmation of B. anthracis. Genotyping of the isolates using multiple-locus variable-number tandem repeat analysis (MLVA) revealed a common source of infection as all three typed isolates had an indistinguishable MLVA genotype, which has not been observed previously in Europe. The results indicate that molecular testing should be selected as the first-line tool for confirming anthrax outbreaks in animals to ensure timely protection of public health.

scholarly journals Standard Genotyping Overestimates Transmission of Mycobacterium tuberculosis among Immigrants in a Low-Incidence Country

2016 ◽  
Vol 54 (7) ◽  
pp. 1862-1870 ◽  
Author(s):  
David Stucki ◽  
Marie Ballif ◽  
Matthias Egger ◽  
Hansjakob Furrer ◽  
Ekkehardt Altpeter ◽  
...  
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Variable Number Tandem Repeat ◽  
Variable Number ◽  
Nucleotide Polymorphisms ◽  
Foreign Born ◽  
Single Nucleotide ◽  
Content Type ◽  
Weak Evidence ◽  
High Incidence ◽  
Low Incidence

Immigrants from regions with a high incidence of tuberculosis (TB) are a risk group for TB in low-incidence countries such as Switzerland. In a previous analysis of a nationwide collection of 520Mycobacterium tuberculosisisolates from 2000 to 2008, we identified 35 clusters comprising 90 patients based on standard genotyping (24-locus mycobacterial interspersed repetitive-unit–variable-number tandem-repeat [MIRU-VNTR] typing and spoligotyping). Here, we used whole-genome sequencing (WGS) to revisit these transmission clusters. Genome-based transmission clusters were defined as isolate pairs separated by ≤12 single nucleotide polymorphisms (SNPs). WGS confirmed 17/35 (49%) MIRU-VNTR typing clusters; the other 18 clusters contained pairs separated by >12 SNPs. Most transmission clusters (3/4) of Swiss-born patients were confirmed by WGS, as opposed to 25% (4/16) of the clusters involving only foreign-born patients. The overall clustering proportion was 17% (90 patients; 95% confidence interval [CI], 14 to 21%) by standard genotyping but only 8% (43 patients; 95% CI, 6 to 11%) by WGS. The clustering proportion was 17% (67/401; 95% CI, 13 to 21%) by standard genotyping and 7% (26/401; 95% CI, 4 to 9%) by WGS among foreign-born patients and 19% (23/119; 95% CI, 13 to 28%) and 14% (17/119; 95% CI, 9 to 22%), respectively, among Swiss-born patients. Using weighted logistic regression, we found weak evidence of an association between birth origin and transmission (adjusted odds ratio of 2.2 and 95% CI of 0.9 to 5.5 comparing Swiss-born patients to others). In conclusion, standard genotyping overestimated recent TB transmission in Switzerland compared to WGS, particularly among immigrants from regions with a high TB incidence, where genetically closely related strains often predominate. We recommend the use of WGS to identify transmission clusters in settings with a low incidence of TB.

scholarly journals Two outbreaks of diarrhoea in nurseries in Norway after farm visits, April to May 2009

2012 ◽  
Vol 17 (47) ◽  
Author(s):  
J Møller-Stray ◽  
H M Eriksen ◽  
T Bruheim ◽  
G Kapperud ◽  
B A Lindstedt ◽  
...  
Keyword(s):  
Public Health ◽  
Retrospective Cohort ◽  
Variable Number Tandem Repeat ◽  
Variable Number ◽  
Farm Animals ◽  
Escherichia Coli O157 ◽  
E Coli ◽  
Repeat Analysis ◽  
Retrospective Cohort Studies ◽  
The One

During a 2009 nationwide outbreak of sorbitol-fermenting Escherichia coli O157 in Norway, the Norwegian Institute of Public Health was notified of diarrhoea outbreaks in two nurseries. A link to the nationwide outbreak was suspected and investigated, including retrospective cohort studies. Both nurseries had recently visited farms. Faecal specimens were obtained from symptomatic children as well as from the farm animals and tested for Campylobacter, Salmonella, Yersinia, Shigella and pathogenic E. coli, and isolates were further characterised. Nursery A had 12 symptomatic children, and we found the same strain of C. jejuni in faeces from children and lambs. Nursery B had nine symptomatic children, including one child with bloody diarrhoea carrying enterohaemorrhagic E. coli (EHEC) O26. EHEC O26 with a similar multiple-locus variable number tandem repeat analysis (MLVA)-profile was found in sheep. Five children had enteropathogenic E. coli (EPEC) O76. Animals were not tested for EPEC O76. We found no significant association between illness and risk factors for either nursery. The isolated pathogens differed from the one involved in the nationwide outbreak. In each nursery outbreak, the pathogens isolated from children matched those found in farm animals, implicating animal faeces as the source. Hygiene messages are important to prevent similar outbreaks.

Oral health diseases among the older people: a general health perspective

2020 ◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Older People ◽  
Health Professionals ◽  
General Health ◽  
Oral Health Care ◽  
Oral Diseases ◽  
Public Health Professionals ◽  
The Relationship

Background: The relationship between oral health and general health is gaining interest in geriatric research; however, a lack of studies dealing with this issue from a general perspective makes it somewhat inaccessible to non-clinical public health professionals. Purpose: The purpose of this review is to describe the relationship between oral health and general health of the elderly on the basis of literature review, and to give non-clinical medical professionals and public health professionals an overview of this discipline. Methods: This study was based on an in-depth review of the literature pertaining to the relationship between oral health and general health among the older people. The tools commonly used to evaluate dental health and the academic researches of male elderly people were also reviewed. And future research directions were summarized. Results: Dental caries, periodontal disease, edentulism, and xerostomia are common oral diseases among the older people. Dental caries and periodontal diseases are the leading causes of missing teeth and edentulism. Xerostomia, similar to dry mouth, is another common oral health disease in the older people. No clear correlation exists between the subjective feeling of dryness and an objective decrease of saliva. Rather, both conditions can be explained by changes in saliva. The General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP) are the main assessment tools used to examine oral health and quality of life in the older people. The GOHAI tends to be more sensitive to objective values pertaining to oral function. In addition, oral health studies in male elderly people are population-based cohort or cross-sectional studies, involving masticatory function, oral prevention, frailty problems, cardiovascular disease risk, and cognitive status. Conclusion: It is possible to reduce the incidence of certain oral diseases, even among individuals who take oral health care seriously. Oral health care should be based on the viewpoint of comprehensive treatment, including adequate nutrition, good life and psychology, and correct oral health care methods. In the future, researchers could combine the results of meta-analysis with the clinical experience of doctors to provide a more in-depth and broader discussion on oral health research topics concerning the older people.

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