Molecular Epidemiology of Tuberculosis

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Abstract
In their excellent review of the molecular epidemiology of tuberculosis, Barnes and Cave (Sept. 18 issue)1 recommend that the Centers for Disease Control and Prevention (CDC) support newer, more rapid genotyping tests. In fact, the CDC is doing just that. This winter, two genotyping laboratories will use two polymerase-chain-reaction–based methods — mycobacterial-interspersed-repetitive-units (MIRU) analysis2 and spoligotyping3 — for primary genotyping of Mycobacterium tuberculosis isolates. The laboratories will have the capacity to analyze isolates from every patient with culture-positive tuberculosis in the United States and will report results in less than two weeks. In combination, these methods are highly discriminatory. For isolates with identical MIRU and spoligotype patterns, a third genotyping method, IS6110-based fingerprinting,4 will be available, if needed, to provide further discriminatory power. We anticipate that rapid access to genotyping results will be a powerful tool for controlling and preventing tuberculosis.5

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