Anne Devallois

Combined numerical analysis based on the molecular description of Mycobacterium tuberculosis by four repetitive sequence-based DNA typing systems

Mycobacterium tuberculosis clinical isolates (113 isolates from 78 patients) were typed using IS6110-RFLP, DR-RFLP, DR-based spoligotyping and direct repetitive element PCR (DRE-PCR). The similarities among isolates were compared for each individual method. The individual matrix distance files for each method were summed and averaged, and the resulting unique distance file was analysed by the UPGMA (unweighted pair group method with arithmetic averages). Combined numerical analysis with 3 genetic markers (IS6110-RFLP, DR-RFLP and spoligotyping) was performed for all 78 clinical isolates, whereas analysis with 4 genetic markers (with the addition of DRE-PCR) was performed on the 10 main clusters described. When compared to molecular analysis based on individual markers, the molecular description based on multiple genetic markers enabled comparison of the results obtained by individual methods and the obtaining of a more accurate view of strain identity and clusters comparison. The resulting cumulative dendrogram was more accurate for studying the population structure of M. tuberculosis and may be a good tool for elucidating intraspecies genetic microevolution.

Computer-assisted analysis of Mycobacterium avium fingerprints using insertion elements IS1245 and IS1311 in a Caribbean setting

A total of 33 clinical isolates of the Mycobacterium avium complex from 25 patients, identified by means of biochemical and cultural characteristics, the Accuprobe system and DT1/DT6 PCR, were further analysed using novel insertion elements IS1245 and IS1311 in a French Caribbean setting. PvuII-cleaved DNA and non-radioactive Southern hybridization and detection systems were used for fingerprinting with both IS elements. The data confirmed the specificity of the two probes for M. avium in our setting and highlighted a significant proportion of M. intracellulare-infected patients in this region. Two distinct groups composed of 2-3 bands and 6-27 bands were found among M. avium isolates, and were composed of the same isolates both with IS1245 and IS1311. The computer analysis of polymorphic banding patterns identified two prevalent genotypes: one contained 4 isolates from 3 patients while a second 2-banded cluster was composed of 6 isolates from 4 patients; all the patients were from the same hospital in Guadeloupe. A single isolate from Martinique was falsely included in the 2-banded cluster initially upon IS1245 fingerprinting, but could be discriminated from other isolates on the basis of IS1311 fingerprinting of PvuII-cleaved DNA. These results were also confirmed upon IS1245 fingerprinting of PstI-digested DNA, as well as DT6 fingerprinting. A single case of polyclonal infection was also discovered in a patient at a 75-day interval. This is the first study comparing the two IS elements and constitutes a first description of disseminated M. avium complex disease from the Caribbean. We conclude that both elements possess a similar discriminatory potential for M. avium isolates. Coupled with computer analysis, this methodology would appear to be particularly suitable for larger epidemiological studies.

Molecular Characterization of Mycobacterium avium Complex Isolates from Caribbean Patients by DT1/DT6-PCR, Nonradioactive Southern Hybridization, and the Accuprobe System

Abstract. A genetic fingerprinting analysis of Caribbean isolates of M. avium complex (MAC) from AIDS patients by a Southern blotting technique after Pstl digestion with nonradioactive DNA probes coding for single-copy sequences DT1 and DT6 was performed. In parallel, a selective amplification of a 187-bp fragment within the DT6 sequence with AV6/AV7 primers for Mycobacterium avium and of a 666-bp fragment within the DT1 sequence of M. intracellulare with the IN38/IN41 primers was also performed, and the molecular speciation with these two methods was compared with results obtained with DNA probes of the Accuprobe system. 66 strains investigated comprised 31 international reference isolates of MAC belonging to serovars 1–28 and 42–44, and 35 clinical isolates including 24 strains from Caribbean AIDS patients. 91.43% of the clinical isolates tested gave concordant data with the DT1/DT6 Southern hybridization and PCR as compared with 74.28% for PCR and Accuprobe, and 71.43% for Accuprobe and Southern hybridization. Our results corroborated previous findings showing that the DT1 probe was specific for M. intracellulare, whereas the DT6 probe was specific for M. avium (reference serovars 2 and 3 probed positive both with DT1 and DT6 probes). Contrary to DT1 probe, which did not reveal sufficient polymorphism to discriminate between MAC isolates, DT6 probe showed an interesting polymorphism giving four distinct clusters. Three clusters corresponded to profiles previously reported for reference and/or clinical isolates; however, a fourth cluster was discovered in five Caribbean isolates from four AIDS patients that did not correspond to previously published genetic patterns. When probed with the insertion sequence IS1245, this cluster retained its homogeneity.