Keywords: Tuberculosis; DNA fingerprinting; molecular epidemiology; multidrug resistance; database
DNA fingerprint techniques have been developed to type Mycobacterium tuberculosis isolates for studying the molecular epidemiology of tuberculosis. The previous concerted action projects have promoted optimal communication between EU partners, thus enabling standardisation of these methods, and meaningful interpretation and comparison of results from epidemiological studies in different areas. In this project, the plan is to maintain the established network in Europe and to use the DNA fingerprint database to trace transmission of (resistant) strains internationally, and to study the natural history and control of tuberculosis. Furthermore, the consortium aims to test the potential of novel genetic markers, derived from the recently established genome sequence of M. tuberculosis, and to explore the DNA chip and microarray technology to allow the use of multiple genetic markers with different molecular clocks.
The treatment of a multidrug resistant tuberculosis case is not only very costly, but also an enormous burden for the concerned patient because of the long term treatment (often many years), the required compliance, the severe side effects caused by the use of multiple drugs, and the containment required at the infectious stage of the disease. Furthermore, treatment is not always successful. Prevention is therefore of vital importance and the surveillance of transmission of (resistant) strains is crucial.
One of the most important aims within this EU project is to establish an international database of DNA fingerprints of multidrug resistant M. tuberculosis isolates. This database will be linked to the EURO-TB surveillance register to enable a meaningful interpretation of the results.
With this information, insight will be gained into the M. tuberculosis strains and genotype families involved in transmission of tuberculosis and outbreaks of this disease.
Dick van Soolingen
National Institute of Public Health and the Environment (RIVM)
P.O. BOX 1
3720 BA Bilthoven
Tel: +31 30 274 2363
Fax: +31 30 274 4418