M.W. Borgdorff, D. van Soolingen Clinical Microbiology and Infection

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The re-emergence of tuberculosis: what have we learnt from molecular epidemiology? M.W. Borgdorff, D. van Soolingen Clinical Microbiology and Infection Volume 19, Issue 10, Pages 889-901 (October 2013) DOI: 10.1111/1469-0691.12253 Copyright © 2013 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 1 Principle of variable-number tandem-repeat (VNTR) typing of Mycobacterium tuberculosis. The number of tandem repeats at each examined locus can differ, and hence the length of the PCR product generated can also differ. By determining the length of the PCR product, the number of tandem repeats present can be deduced. As this is done for 24 loci in the genome of M. tuberculosis, the standard VNTR pattern is a numerical code of 24 numbers. Clinical Microbiology and Infection 2013 19, 889-901DOI: (10.1111/1469-0691.12253) Copyright © 2013 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 2 Mutations in the regulatory network are associated with the recent clonal expansion of a dominant subclone of the Mycobacterium tuberculosis Beijing genotype. The hypothetical phylogenetic tree of the Beijing genotype strains of M. tuberculosis is shown. The atypical Beijing strains are genetically diverse. The typical strains presumably gained a selective advantage over the atypical strains, and started to spread recently. The currently isolated typical Beijing strains from a widespread geographical area are highly clonal, which may be related to an enhanced capacity to circumvent bacille Calmette–Guérin-induced immunity or to withstand treatment with antituberculosis drugs. Clinical Microbiology and Infection 2013 19, 889-901DOI: (10.1111/1469-0691.12253) Copyright © 2013 European Society of Clinical Infectious Diseases Terms and Conditions

Fig. 3 Stability of the Mycobacterium tuberculosis genome in a chain of transmission spanning 14 years. In order to examine the highest resolution of DNA typing, the strain that caused the Harlingen outbreak in The Netherlands in 1993 was subjected to whole genome sequencing. The sequence of an isolate in 1993 was compared with that of an isolate of the same strain in 2006, after it had been passed on through four patients to a fifth patient. Clinical Microbiology and Infection 2013 19, 889-901DOI: (10.1111/1469-0691.12253) Copyright © 2013 European Society of Clinical Infectious Diseases Terms and Conditions