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A dominant Mycobacterium tuberculosis strain emerging in Denmark
T Lillebaek1, A Dirksen, A Kok-Jensen
1International Reference Laboratory of Mycobacteriology, Statens Serum Institute, Copenhagen, Denmark. tll@ssi.dk
Summary
A specific tuberculosis strain rapidly emerged in Denmark, becoming more prevalent in younger males with pulmonary disease. This situation requires increased focus on early diagnosis and transmission control.
Area of Science:
- Epidemiology
- Molecular Biology
- Public Health
Background:
- Tuberculosis (TB) remains a global health concern, with distinct Mycobacterium tuberculosis strains linked to outbreaks.
- Molecular epidemiology aids in tracking TB transmission patterns and identifying specific strains.
Purpose of the Study:
- To conduct the first population-based search for distinct Mycobacterium tuberculosis strains in Denmark.
- To analyze the prevalence and characteristics of M. tuberculosis strains nationwide from 1992 to 2001.
Main Methods:
- DNA fingerprinting of 4102 M. tuberculosis strains collected nationwide.
- Comparative analysis of demographic and clinical data for cases infected with different strains.
Main Results:
- A specific strain, Danish Cluster 2, rapidly increased in prevalence from 5.8% in 1992 to 29.0% in 2001.
- Cluster 2 cases were younger, more frequently male, and had a higher likelihood of pulmonary-only TB.
- The geographical distribution of Cluster 2 shifted from the capital to provinces over the study period.
Conclusions:
- The increasing dominance of Cluster 2 strains suggests an ongoing outbreak in Denmark.
- The strain's association with younger males and pulmonary TB may explain its spread.
- Enhanced focus on early TB diagnosis and transmission control is recommended.