 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Amy S. Piatek, MS1, Carla M. Clark, MPH1, Cynthia R. Driver, RN, MPH1, Benyang Zhao, PhD2, Jeffrey R. Driscoll, PhD3, Barry N. Kreiswirth, PhD4, and Sonal S. Munsiff, MD1. (1) Bureau of Tuberculosis Control, New York City Department of Health and Mental Hygiene, 225 Broadway, 22nd Floor, New York, NY 10007, 212-442-9940, apiatek@health.nyc.gov, (2) Public Health Laboratories, New York City Department of Health and Mental Hygiene, 455 1st Avenue, New York, NY 10016, (3) Wadsworth Center, New York State Department of Health, P.O. Box 22002, New Scotland Avenue, Albany, NY 12201-2002, (4) Tuberculosis Center, Public Health Research Institute, 225 Warren Street, Newark, NJ 07103
The NYC Bureau of Tuberculosis Control (BTBC) Molecular Epidemiology (ME) Project was implemented to expand the effectiveness of TB control by efficiently identifying false-positive cultures and on-going TB transmission using DNA analysis along with standard surveillance epidemiology methods. As of January 2001, all clinical laboratories have been mandated to forward the initial M. tuberculosis culture from each NYC patient to the Public Health Laboratories within 24 hours of identification. DNA analysis by both spoligotyping and IS6110-RFLP methods is done by NYS Wadsworth Laboratory and the Public Health Research Institute, respectively. The NYC BTBC analyzes all results. A ME Workgroup meets bimonthly, consisting of representatives from the BTBC and key laboratories. To date, 92.2% of initial M. tuberculosis cultures were submitted for DNA analysis, of which 90% have complete fingerprinting results. Results for spoligotyping were available on average in 7 days in first quarter 2001 and decreased to 1 day in last quarter 2002, and for IS6110-RFLP in 40 and 19 days, respectively. Within the study period, 490 cases (34%) had identical strains comprising 132 clusters, which ranged from 2-47 cases per cluster. Of the strains with a DNA fingerprint, 3.2% were confirmed as having a false-positive culture. Despite the large number of laboratories involved in diagnosing tuberculosis in NYC, participation in the ME project has been high. Time to obtaining fingerprinting results has decreased for spoligotyping and IS6110-RFLP. Future efforts will focus on real-time analysis of potential false-positive cultures and clusters.
Learning Objectives:
Keywords: TB, Epidemiology
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.