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Mycobacterium tuberculosis transmission in Birmingham, UK, 2009–19: An observational study
Over 10-years of whole-genome sequencing (WGS) of Mycobacterium tuberculosis in Birmingham presents an opportunity to explore epidemiological trends and risk factors for transmission in new detail. Between 1st January 2009 and 15th June 2019, we obtained the first WGS isolate from every patient resi...
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Published in: | The Lancet regional health. Europe 2022-06, Vol.17, p.100361-100361, Article 100361 |
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creator | Walker, Timothy M. Choisy, Marc Dedicoat, Martin Drennan, Philip G. Wyllie, David Yang-Turner, Fan Crook, Derrick W. Robinson, Esther R. Walker, A. Sarah Smith, E. Grace Peto, Timothy E.A. |
description | Over 10-years of whole-genome sequencing (WGS) of Mycobacterium tuberculosis in Birmingham presents an opportunity to explore epidemiological trends and risk factors for transmission in new detail.
Between 1st January 2009 and 15th June 2019, we obtained the first WGS isolate from every patient resident in a postcode district covered by Birmingham's centralised tuberculosis service. Data on patients’ sex, country of birth, social risk-factors, anatomical locus of disease, and strain lineage were collected. Poisson harmonic regression was used to assess seasonal variation in case load and a mixed-effects multivariable Cox proportionate hazards model was used to assess risk factors for a future case arising in clusters defined by a 5 single nucleotide polymorphism (SNP) threshold, and by 12 SNPs in a sensitivity analysis.
511/1653 (31%) patients were genomically clustered with another. A seasonal variation in diagnoses was observed, peaking in spring, but only among clustered cases. Risk-factors for a future clustered case included UK-birth (aHR=2·03 (95%CI 1·35–3·04), p |
doi_str_mv | 10.1016/j.lanepe.2022.100361 |
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Between 1st January 2009 and 15th June 2019, we obtained the first WGS isolate from every patient resident in a postcode district covered by Birmingham's centralised tuberculosis service. Data on patients’ sex, country of birth, social risk-factors, anatomical locus of disease, and strain lineage were collected. Poisson harmonic regression was used to assess seasonal variation in case load and a mixed-effects multivariable Cox proportionate hazards model was used to assess risk factors for a future case arising in clusters defined by a 5 single nucleotide polymorphism (SNP) threshold, and by 12 SNPs in a sensitivity analysis.
511/1653 (31%) patients were genomically clustered with another. A seasonal variation in diagnoses was observed, peaking in spring, but only among clustered cases. Risk-factors for a future clustered case included UK-birth (aHR=2·03 (95%CI 1·35–3·04), p < 0·001), infectious (pulmonary/laryngeal/miliary) tuberculosis (aHR=3·08 (95%CI 1·98-4·78), p < 0·001), and M. tuberculosis lineage 3 (aHR=1·91 (95%CI 1·03–3·56), p = 0·041) and 4 (aHR=2·27 (95%CI 1·21–4·26), p = 0·011), vs. lineage 1. Similar results pertained to 12 SNP clusters, for which social risk-factors were also significant (aHR 1·72 (95%CI 1·02–2·93), p = 0·044). There was marked heterogeneity in transmission patterns between postcode districts.
There is seasonal variation in the diagnosis of genomically clustered, but not non-clustered, cases. Risk factors for clustering include UK-birth, infectious forms of tuberculosis, and infection with lineage 3 or 4.
Wellcome Trust, MRC, UKHSA</description><identifier>ISSN: 2666-7762</identifier><identifier>EISSN: 2666-7762</identifier><identifier>DOI: 10.1016/j.lanepe.2022.100361</identifier><identifier>PMID: 35345560</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Epidemiology ; Mycobacterium tuberculosis ; Seasonality ; Transmission ; Whole genome sequencing</subject><ispartof>The Lancet regional health. Europe, 2022-06, Vol.17, p.100361-100361, Article 100361</ispartof><rights>2022</rights><rights>2022 The Author(s).</rights><rights>2022 The Author(s) 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4441-9833f82247a7c620eaf224047f14922067a1fbc38ef212e75555c070fdd1f19f3</citedby><cites>FETCH-LOGICAL-c4441-9833f82247a7c620eaf224047f14922067a1fbc38ef212e75555c070fdd1f19f3</cites><orcidid>0000-0003-0421-9264</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8956939/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2666776222000540$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,3549,27924,27925,45780,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35345560$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walker, Timothy M.</creatorcontrib><creatorcontrib>Choisy, Marc</creatorcontrib><creatorcontrib>Dedicoat, Martin</creatorcontrib><creatorcontrib>Drennan, Philip G.</creatorcontrib><creatorcontrib>Wyllie, David</creatorcontrib><creatorcontrib>Yang-Turner, Fan</creatorcontrib><creatorcontrib>Crook, Derrick W.</creatorcontrib><creatorcontrib>Robinson, Esther R.</creatorcontrib><creatorcontrib>Walker, A. Sarah</creatorcontrib><creatorcontrib>Smith, E. Grace</creatorcontrib><creatorcontrib>Peto, Timothy E.A.</creatorcontrib><title>Mycobacterium tuberculosis transmission in Birmingham, UK, 2009–19: An observational study</title><title>The Lancet regional health. Europe</title><addtitle>Lancet Reg Health Eur</addtitle><description>Over 10-years of whole-genome sequencing (WGS) of Mycobacterium tuberculosis in Birmingham presents an opportunity to explore epidemiological trends and risk factors for transmission in new detail.
Between 1st January 2009 and 15th June 2019, we obtained the first WGS isolate from every patient resident in a postcode district covered by Birmingham's centralised tuberculosis service. Data on patients’ sex, country of birth, social risk-factors, anatomical locus of disease, and strain lineage were collected. Poisson harmonic regression was used to assess seasonal variation in case load and a mixed-effects multivariable Cox proportionate hazards model was used to assess risk factors for a future case arising in clusters defined by a 5 single nucleotide polymorphism (SNP) threshold, and by 12 SNPs in a sensitivity analysis.
511/1653 (31%) patients were genomically clustered with another. A seasonal variation in diagnoses was observed, peaking in spring, but only among clustered cases. Risk-factors for a future clustered case included UK-birth (aHR=2·03 (95%CI 1·35–3·04), p < 0·001), infectious (pulmonary/laryngeal/miliary) tuberculosis (aHR=3·08 (95%CI 1·98-4·78), p < 0·001), and M. tuberculosis lineage 3 (aHR=1·91 (95%CI 1·03–3·56), p = 0·041) and 4 (aHR=2·27 (95%CI 1·21–4·26), p = 0·011), vs. lineage 1. Similar results pertained to 12 SNP clusters, for which social risk-factors were also significant (aHR 1·72 (95%CI 1·02–2·93), p = 0·044). There was marked heterogeneity in transmission patterns between postcode districts.
There is seasonal variation in the diagnosis of genomically clustered, but not non-clustered, cases. Risk factors for clustering include UK-birth, infectious forms of tuberculosis, and infection with lineage 3 or 4.
Wellcome Trust, MRC, UKHSA</description><subject>Epidemiology</subject><subject>Mycobacterium tuberculosis</subject><subject>Seasonality</subject><subject>Transmission</subject><subject>Whole genome sequencing</subject><issn>2666-7762</issn><issn>2666-7762</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNp9kc9u1DAQxiMEolXpGyCUI4fuYo8dO-aAVCr-VBRxoTcky3HGW6-SeLGTlfbGO_CGPAkOKaW9MBfb45lv7O9XFM8pWVNCxavtujMD7nANBCCnCBP0UXEMQoiVlAIe39sfFacpbQkhUFEGlD8tjljFeFUJclx8-3ywoTF2xOinvhynBqOdupB8KsdohtT7lHwYSj-Ub33s_bC5Mf1Zef3prARC1K8fP6l6XZ4PZWgSxr0Zc7HpyjRO7eFZ8cSZLuHp7XpSXL9_9_Xi4-rqy4fLi_OrleWc05WqGXM1AJdGWgEEjcsHwqWjXAEQIQ11jWU1OqCAssphiSSubamjyrGT4nLRbYPZ6l30vYkHHYzXfxIhbrSJo7cdasoQXUWcaa3hFlUDNZcAgomqzjFrvVm0dlPTY2txyDZ0D0Qf3gz-Rm_CXteqEoqpLPDyViCG7xOmUWcLLXYzsDAlDYJzxSup5lK-lNoYUoro7sZQomfOeqsXznrmrBfOue3F_SfeNf2l-u8PmE3fe4w6WY-DxdZHtGN2xf9_wm9oPrr0</recordid><startdate>20220601</startdate><enddate>20220601</enddate><creator>Walker, Timothy M.</creator><creator>Choisy, Marc</creator><creator>Dedicoat, Martin</creator><creator>Drennan, Philip G.</creator><creator>Wyllie, David</creator><creator>Yang-Turner, Fan</creator><creator>Crook, Derrick W.</creator><creator>Robinson, Esther R.</creator><creator>Walker, A. Sarah</creator><creator>Smith, E. Grace</creator><creator>Peto, Timothy E.A.</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0421-9264</orcidid></search><sort><creationdate>20220601</creationdate><title>Mycobacterium tuberculosis transmission in Birmingham, UK, 2009–19: An observational study</title><author>Walker, Timothy M. ; Choisy, Marc ; Dedicoat, Martin ; Drennan, Philip G. ; Wyllie, David ; Yang-Turner, Fan ; Crook, Derrick W. ; Robinson, Esther R. ; Walker, A. Sarah ; Smith, E. Grace ; Peto, Timothy E.A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4441-9833f82247a7c620eaf224047f14922067a1fbc38ef212e75555c070fdd1f19f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Epidemiology</topic><topic>Mycobacterium tuberculosis</topic><topic>Seasonality</topic><topic>Transmission</topic><topic>Whole genome sequencing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walker, Timothy M.</creatorcontrib><creatorcontrib>Choisy, Marc</creatorcontrib><creatorcontrib>Dedicoat, Martin</creatorcontrib><creatorcontrib>Drennan, Philip G.</creatorcontrib><creatorcontrib>Wyllie, David</creatorcontrib><creatorcontrib>Yang-Turner, Fan</creatorcontrib><creatorcontrib>Crook, Derrick W.</creatorcontrib><creatorcontrib>Robinson, Esther R.</creatorcontrib><creatorcontrib>Walker, A. Sarah</creatorcontrib><creatorcontrib>Smith, E. Grace</creatorcontrib><creatorcontrib>Peto, Timothy E.A.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>The Lancet regional health. Europe</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walker, Timothy M.</au><au>Choisy, Marc</au><au>Dedicoat, Martin</au><au>Drennan, Philip G.</au><au>Wyllie, David</au><au>Yang-Turner, Fan</au><au>Crook, Derrick W.</au><au>Robinson, Esther R.</au><au>Walker, A. Sarah</au><au>Smith, E. Grace</au><au>Peto, Timothy E.A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mycobacterium tuberculosis transmission in Birmingham, UK, 2009–19: An observational study</atitle><jtitle>The Lancet regional health. Europe</jtitle><addtitle>Lancet Reg Health Eur</addtitle><date>2022-06-01</date><risdate>2022</risdate><volume>17</volume><spage>100361</spage><epage>100361</epage><pages>100361-100361</pages><artnum>100361</artnum><issn>2666-7762</issn><eissn>2666-7762</eissn><abstract>Over 10-years of whole-genome sequencing (WGS) of Mycobacterium tuberculosis in Birmingham presents an opportunity to explore epidemiological trends and risk factors for transmission in new detail.
Between 1st January 2009 and 15th June 2019, we obtained the first WGS isolate from every patient resident in a postcode district covered by Birmingham's centralised tuberculosis service. Data on patients’ sex, country of birth, social risk-factors, anatomical locus of disease, and strain lineage were collected. Poisson harmonic regression was used to assess seasonal variation in case load and a mixed-effects multivariable Cox proportionate hazards model was used to assess risk factors for a future case arising in clusters defined by a 5 single nucleotide polymorphism (SNP) threshold, and by 12 SNPs in a sensitivity analysis.
511/1653 (31%) patients were genomically clustered with another. A seasonal variation in diagnoses was observed, peaking in spring, but only among clustered cases. Risk-factors for a future clustered case included UK-birth (aHR=2·03 (95%CI 1·35–3·04), p < 0·001), infectious (pulmonary/laryngeal/miliary) tuberculosis (aHR=3·08 (95%CI 1·98-4·78), p < 0·001), and M. tuberculosis lineage 3 (aHR=1·91 (95%CI 1·03–3·56), p = 0·041) and 4 (aHR=2·27 (95%CI 1·21–4·26), p = 0·011), vs. lineage 1. Similar results pertained to 12 SNP clusters, for which social risk-factors were also significant (aHR 1·72 (95%CI 1·02–2·93), p = 0·044). There was marked heterogeneity in transmission patterns between postcode districts.
There is seasonal variation in the diagnosis of genomically clustered, but not non-clustered, cases. Risk factors for clustering include UK-birth, infectious forms of tuberculosis, and infection with lineage 3 or 4.
Wellcome Trust, MRC, UKHSA</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>35345560</pmid><doi>10.1016/j.lanepe.2022.100361</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0003-0421-9264</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Epidemiology Mycobacterium tuberculosis Seasonality Transmission Whole genome sequencing |
title | Mycobacterium tuberculosis transmission in Birmingham, UK, 2009–19: An observational study |
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