Guide to the Application of Genotyping to Tuberculosis Prevention and Control

Handbook for TB Controllers, Epidemiologists, Laboratorians, and Other Program Staff — June 2004

Table of Contents

Acknowledgments

1. Introduction to Tuberculosis Genotyping
   • Introduction to this Guide
   • Overview of Tuberculosis Genotyping
   • Overview of the CDC Tuberculosis Genotyping Program
   • TB Program Eligibility and Application Procedures
     
     
2. Tuberculosis Genotyping Case Studies
   • Investigation of a Genotyping Cluster in a Low-Incidence State
   • Apparent Genotyping Cluster among Recent Immigrants from the Philippines
   • False-Positive Culture Investigation
   • Algorithm to Detect False-Positive Cultures
   • A Misdiagnosis that was Identified with Genotyping
   • Genotyping Used to Improve Contact and Cluster Investigations
   • Identification of Nontraditional Transmission Settings
   • Investigation of a Multistate Tuberculosis Outbreak
   • Homeless Shelter Outbreak Investigation
   • Using Genotyping to Evaluate the Impact of a Screening Program
     
     
3. CDC Tuberculosis Genotyping Laboratory Procedures
   • Science behind Tuberculosis Genotyping
   • Description of Genotyping Methods
   • Submission of Isolates
   • Genotyping Results, Designation of Clusters, and Reporting
   • Suspected False-Positive Cultures
   • IS6110-based RFLP Analysis
     
     
4. Combining Genotyping and Epidemiologic Data to Improve Our Understanding of Tuberculosis Transmission
   • Definitions
   • Reading the Genotyping Laboratory Report
   • Comparing Genotyping and Epidemiologic Results from Two TB Patients
   • Comparing Genotyping and Epidemiologic Results from Three or More TB Patients
   • Clustering as a Surrogate Measure of Recent Transmission
     
     
5. Developing a Tuberculosis Genotyping Program
   • Developing a Written Plan
   • Initial Decisions
   • Establishing Procedures for:
     • Submitting Isolates
     • Receiving and Acting on Genotyping Results
     • Requesting RFLP Analysis
     • Submitting Additional Isolates from the Same Patient
   • Comparing Genotyping Results between Jurisdictions
   • False-Positive Cultures
   • Database Management and Quality Control
   • Special Issues
     
     
6. Applying Genotyping Results to Tuberculosis Control Practices
   • Evaluating Matching Genotypes
   • Evaluating Nonmatching Genotypes
   • Suspected False-Positive Culture Investigations
   • Expanded Contact Investigations
   • Outbreak Investigations
   • Cluster Investigations
   • Monitoring Trends
     
     
7. Appendices
   • Appendix A: Glossary and Abbreviations
   • Appendix B: References and Useful Resources
     • References Cited in the Guide
     • NTGSN Special Issue References
     • Information on Packaging and Shipping Infectious Substances
     • Core Steps of an Outbreak Investigation
     • Consultants Available to Offer Guidance
       

An electronic copy of this guide, the Isolate Submission Form, and other genotyping documents can be downloaded from the CDC Tuberculosis Genotyping Program’s WebBoard.

Free copies of the guide can be ordered by contacting the TB genotyping program at: tbgenotyping@cdc.gov.

Prepared by the National Tuberculosis Controllers Association / Centers for Disease Control and Prevention Advisory Group on Tuberculosis Genotyping

Suggested citation: National TB Controllers Association / CDC Advisory Group on Tuberculosis Genotyping. Guide to the Application of Genotyping to Tuberculosis Prevention and Control. Atlanta, GA: US Department of Health and Human Services, CDC; June 2004.