Document 0844
 DOCN  M9480844
 TI    Molecular epidemiology of tuberculosis in New York City.
 DT    9410
 AU    Friedman CR; Riley L; Kreiswirth B; Johnson WD; Manoach S; Sathianathan
       K; Stoeckle MY; Cornell University Medical College, Public Health
       Research; Institute, New York, N.Y.
 SO    Abstr Gen Meet Am Soc Microbiol. 1994;94:550 (abstract no. C-342).
       Unique Identifier : AIDSLINE ASM94/94313101
 AB    Tuberculosis (TB) in the United States is usually due to reactivation,
       but may occur as a result of recent exogenous infection. Restriction
       Fragment Length Polymorphism (RFLP) analysis has been used to identify
       clonal spread of recent TB infection. We used RFLP analysis to determine
       the pattern of transmission of TB in New York City. We performed RFLP
       analysis on TB isolates obtained during 1992 at four New York City
       hospitals (TBNetwork), which had no recognized TB outbreaks. Eighty-one
       isolates were analyzed. Thirteen of 81 (16%) were multi-drug resistant
       (MDR), 7 (9%) were resistant to INH alone, and 58 (72%) were
       drug-sensitive. Sixteen different RFLP patterns that were previously
       determined to be clonal in origin were found in 36 of the 81 isolates
       (44%). Forty-five distinct (non-clonal) RFLP patterns were found in the
       remaining 45 isolates (56%). A clonal pattern was found in 11 of 13
       (85%) MDRTB isolates and 23 of 65 (35%) non-MDR strains (p = .003,
       Yates). Among isolates from patients with known HIV status, a clonal
       RFLP pattern was observed in 18 of 30 (60%) HIV-seropositive patients
       and 9 of 28 (32%) HIV-seronegative patients. These results indicate that
       recent exogenous infection is playing a major role in the TB epidemic in
       New York City, particularly in persons with HIV and MDRTB.
 DE    AIDS-Related Opportunistic Infections/EPIDEMIOLOGY/TRANSMISSION
       Comparative Study  Drug Resistance, Microbial  Hospitals, Urban  Human
       HIV Seronegativity  HIV Seropositivity  New York City/EPIDEMIOLOGY
       *Restriction Fragment Length Polymorphisms
       Tuberculosis/DIAGNOSIS/*EPIDEMIOLOGY/TRANSMISSION  MEETING ABSTRACT

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