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Clinical Microbiology Reviews, October 2006, p. 658-685, Vol. 19, No. 4
0893-8512/06/$08.00+0     doi:10.1128/CMR.00061-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Molecular Epidemiology of Tuberculosis: Current Insights

Barun Mathema,1,2 Natalia E. Kurepina,1 Pablo J. Bifani,3 and Barry N. Kreiswirth1*

Tuberculosis Center, Public Health Research Institute, Newark, New Jersey,1 Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York,2 Molecular Pathology of Tuberculosis, Pasteur Institute, Brussels, Belgium3

Molecular epidemiologic studies of tuberculosis (TB) have focused largely on utilizing molecular techniques to address short- and long-term epidemiologic questions, such as in outbreak investigations and in assessing the global dissemination of strains, respectively. This is done primarily by examining the extent of genetic diversity of clinical strains of Mycobacterium tuberculosis. When molecular methods are used in conjunction with classical epidemiology, their utility for TB control has been realized. For instance, molecular epidemiologic studies have added much-needed accuracy and precision in describing transmission dynamics, and they have facilitated investigation of previously unresolved issues, such as estimates of recent-versus-reactive disease and the extent of exogenous reinfection. In addition, there is mounting evidence to suggest that specific strains of M. tuberculosis belonging to discrete phylogenetic clusters (lineages) may differ in virulence, pathogenesis, and epidemiologic characteristics, all of which may significantly impact TB control and vaccine development strategies. Here, we review the current methods, concepts, and applications of molecular approaches used to better understand the epidemiology of TB.


* Corresponding author. Mailing address: Tuberculosis Center, Public Health Research Institute, Newark, NJ 07103. Phone: (973) 854-3240. Fax: (973) 854-3241. E-mail: barry{at}phri.org.


Clinical Microbiology Reviews, October 2006, p. 658-685, Vol. 19, No. 4
0893-8512/06/$08.00+0     doi:10.1128/CMR.00061-05
Copyright © 2006, American Society for Microbiology. All Rights Reserved.




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