Am. J. Respir. Crit. Care Med., Volume 164, Number 7, October 2001, 1165-1170

Epidemiological Evidence of the Spread of a Mycobacterium tuberculosis Strain of the Beijing Genotype on Gran Canaria Island

JOSÉ A. CAMINERO, MARÍA J. PENA, MARÍA I. CAMPOS-HERRERO, JOSÉ C. RODRÍGUEZ, ISABEL GARCÍA, PEDRO CABRERA, CARMEN LAFOZ, SOFÍA SAMPER, HOWARD TAKIFF, OCTAVIO AFONSO, JOSÉ M. PAVÓN, MARÍA JOSÉ TORRES, DICK VAN SOOLINGEN, DONALD A. ENARSON, and CARLOS MARTIN

Service of Pneumology, Service of Microbiology, Service of Immunology, Emergency Department, and Investigation Unit, University General Hospital Dr. Negrín, Las Palmas de Gran Canaria, Spain; International Union Against Tuberculosis and Lung Diseases (IUATLD), Paris, France; Department of Microbiology, University of Zaragoza, Zaragoza, Spain; Laboratorio de Genética Molecular, Instituto Venezolano de Investigaciones Científicas, Caracas, Venezuela; and Mycobacterial Department, Diagnostic Laboratory for Infectious Diseases and Perinatal Screening, National Institute of Public Health and the Environment, Bilthoven, The Netherlands

Molecular epidemiological studies suggest that particular Mycobacterium tuberculosis strains have an enhanced capacity to spread within a community. One strain, the Beijing genotype, has been associated with outbreaks in a number of communities throughout the world. IS6110 restriction fragment length polymorphism (RFLP) analysis was performed on M. tuberculosis isolates from 566 of the 721 patients (78.5%) diagnosed with tuberculosis (TB) on Gran Canaria Island from 1993 to 1996, as well as 35% of isolates from 1991-1992 (85 strains). RFLP identification of the family of strains of the Beijing genotype was confirmed by spoligotyping. Medical records of all patients were reviewed and epidemiological links were identified. Of 566 M. tuberculosis isolates from 1993 to 1996 with RFLP available, 72% belonged to clusters. The largest contained 75 cases and was caused by a strain of the Beijing genotype that was introduced to the island in 1993. It was found in 10 patients in 1993 (5.5%), 12 in 1994 (8.1%), 18 in 1995 (16.4%), and 35 in 1996 (27.1%). Epidemiological linkage was confirmed for 68% of cases. This study has demonstrated rapid dissemination of this strain of the Beijing genotype. This genotype might play an important role in the future of the worldwide tuberculosis epidemic.

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