%0 Journal Article %T [Molecular strain typing contribution to epidemiology of tuberculosis in Limousin (1998 to 2006)] : Intérêt du typage moléculaire pour l'épidémiologie de la tuberculose en Limousin (1998-2006) %+ Service de Médecine interne A et polyclinique médicale [CHU Limoges] %+ Biologie moléculaire et cellulaire des microorganismes (EA3175) %+ Service de Bactériologie, Virologie, Hygiène [CHU Limoges] %+ Institut de génétique et microbiologie [Orsay] (IGM) %+ Génétique mycobactérienne - Mycobacterial genetics %+ Service de Pathologie respiratoire et allergologie [CHU Limoges] %+ Service d'Hématologie clinique et thérapie cellulaire [CHU Limoges] %+ Service des Maladies infectieuses et tropicales [CHU Limoges] %+ Equipe de Recherche Médicale Appliquée (ERMA) %+ Université de Limoges (UNILIM) %A Bezanahary, Holy %A Baclet, M.-C. %A Sola, Christophe %A Gazaille, Virgile %A Turlure, Pascal %A Weinbreck, Pierre %A Denis, François %A Martin, Christian %Z ERMA %< avec comité de lecture %@ 0399-077X %J Médecine et Maladies Infectieuses %I Elsevier Masson %V 38 %N 6 %P 309-317 %8 2008-06 %D 2008 %R 10.1016/j.medmal.2008.02.008 %M 18395379 %Z Life Sciences [q-bio]/Santé publique et épidémiologieJournal articles %X OBJECTIVES: We conducted a molecular epidemiology of Mycobacterium tuberculosis in Limousin, a French area with a low incidence of tuberculosis (4.8/100,000 inhabitants in 2005) to define the molecular diversity and the pattern of transmission. DESIGN: Two hundred and fifty-nine strains were isolated (each strain corresponds to one patient) from 1998 to 2006. Both spoligotyping and MIRU15 were chosen for our study because of their discriminatory power. RESULTS: Only 165 medical records were available: 99M/66F, mean age 56.4 years (14-94), 32.7% foreign-born patients, 16.9% homeless or living in shelters, 21.8% of immunocompromised patients (three HIV positive), 14.5% of alcohol addicts. Pulmonary manifestations were predominant (81.8%) with 45.1% of positive smears. Two strains among the 259 presented a multidrug resistance. Spoligotyping identified 136/259 spoligotypes (110 unique, 26 clusters composed of two to 36 isolates); within these 26 clusters, ST53 (n=36) and ST50 (n=19) were the most frequent. Three major families were observed as follow: T1 (30%), Haarlem (30%) and LAM (20%). MIRU15 identified 28/36 isolates in the ST53 group and 14/19 in the ST50 group. Eleven clusters (32 strains) with identical ST-MIRU15 were obtained with a proved case of recent transmission. Alcohol dependence, immunosuppression and pulmonary infections seem to be involved in transmission factors. CONCLUSION: M. tuberculosis strains isolated in Limousin are characterized by their high genetic diversity. The rate of recent transmission (8.1%) is low and therefore a reactivation process is predominant in this area. %G French %L hal-00742153 %U https://unilim.hal.science/hal-00742153 %~ PASTEUR %~ UNILIM %~ CNRS %~ UNIV-PSUD %~ SANTE_PUB_INSERM %~ UMR-S1092 %~ RIIP_PARIS %~ ERMA %~ GEIST %~ I2BC %~ UNIV-PARIS-SACLAY %~ UNIV-PSUD-SACLAY %~ GS-HEALTH-DRUG-SCIENCES %~ OMEGAHEALTH %~ TEST3-HALCNRS