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XDR-TB transmission in London: Case management and contact tracing investigation assisted by early whole genome sequencing.

Arnold, A; Witney, AA; Vergnano, S; Roche, A; Cosgrove, CA; Houston, A; Gould, KA; Hinds, J; Riley, P; Macallan, D; et al. Arnold, A; Witney, AA; Vergnano, S; Roche, A; Cosgrove, CA; Houston, A; Gould, KA; Hinds, J; Riley, P; Macallan, D; Butcher, PD; Harrison, TS (2016) XDR-TB transmission in London: Case management and contact tracing investigation assisted by early whole genome sequencing. Journal of Infection, 73 (3). pp. 210-218. ISSN 0163-4453 https://doi.org/10.1016/j.jinf.2016.04.037
SGUL Authors: Butcher, Philip David Hinds, Jason Witney, Adam Austin

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Abstract

OBJECTIVES: We describe the first published cluster of extensively drug resistant Tuberculosis (XDR-TB) in the UK and show how early whole genome sequencing (WGS) of Mtb can assist in case management and contact investigations. METHODS: We describe the contact tracing investigation undertaken after the presentation of an adult with XDR-TB. Active cases were treated with an XDR-TB drug regimen and contacts underwent a programme of follow-up for 2 years. All isolates of Mycobacterium tuberculosis (Mtb) were assessed early using whole genome sequencing (WGS) as well as routine drug susceptibility testing (DST). RESULTS: Thirty-three contacts were screened. In the first year one confirmed and one probable case were identified through contact tracing. A further possible case was identified through epidemiological links. Two confirmed cases were identified through WGS 2 years later. Twenty-five (80%) contacts without evidence of tuberculosis were adherent to 1 year of follow-up and 14 (45%) were adherent to 2 years of follow-up. WGS of Mtb was used to guide drug choices, rapidly identify transmission events, and alter public health management. CONCLUSION: WGS of Mtb enabled rapid effective individualized treatment and facilitated public health interventions by early identification of transmission events.

Item Type: Article
Additional Information: © 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Contact tracing, Disease outbreaks, Drug resistance, Pathology, molecular, Tuberculosis, Microbiology, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Journal of Infection
ISSN: 0163-4453
Language: ENG
Dates:
DateEvent
14 June 2016Published Online
20 April 2016Accepted
1 September 2016Published
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
PubMed ID: 27311749
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/108016
Publisher's version: https://doi.org/10.1016/j.jinf.2016.04.037

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