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Guide to the Application of Genotyping to Tuberculosis Prevention and Control										Related Pages
										**Introduction to Tuberculosis Genotyping**
**Introduction to this Guide**
This guide provides an introduction to the application of tuberculosis (TB) genotyping to TB control practices and to the Centers for Disease Control and Prevention (CDC) TB Genotyping Program. It was written by the National Tuberculosis Controllers Association (NTCA)/CDC Advisory Group on Tuberculosis Genotyping and is intended for TB controllers, epidemiologists, laboratorians, and other program staff members who will be involved in submitting isolates for genotyping, analyzing and responding to genotyping results, or using genotyping data to monitor TB transmission trends.
This guide does not contain specific directions on how a TB control program must carry out its genotyping program. The CDC genotyping program is not a research effort, and participating state and local programs are not required to carry out a protocol, submit a certain number of isolates, or collect specific data. Rather, this guide provides general guidance about how to utilize the genotyping laboratories, how to understand genotyping results, and how to apply those results to improve TB control practices. For those interested in the specific procedures used by other TB genotyping programs, the Maryland TB program and the New York City TB program have agreed to share their procedure manuals; those documents can be downloaded from our TB genotyping WebBoard at http://web-tb.forum.cdc.gov.
Understanding TB genotyping results is not difficult, but it involves learning a new vocabulary. It also involves establishing new procedures to ensure that the genotyping results can easily be combined with appropriate epidemiologic data to identify instances of recent TB transmission. This new vocabulary and these new procedures are the focus of this guide. Hopefully, we have developed a guide that helps you master this new subject.
In the following paragraphs, key concepts are introduced. These concepts are developed further in the relevant chapters of the guide. Finally, a glossary in Appendix A defines important concepts. Throughout the guide, tables, figures, and text boxes sum up important points made in the text. 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 at http://web-tb.forum.cdc.gov. Copies of the guide can be ordered by sending an e-mail to TBGenotyping@cdc.gov.
							
					
						Page last reviewed:  September 1, 2012					Content source: 	Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention homeGuide to the Application of Genotyping to Tuberculosis Prevention and Control
Acknowledgments
Introduction to Tuberculosis Genotypingminus icon
Introduction to this Guide
Overview of Tuberculosis Genotyping
Overview of the CDC Tuberculosis Genotyping Program
TB Program Eligibility and Application Procedures
Tuberculosis Genotyping Case Studiesplus icon
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
CDC Tuberculosis Genotyping Laboratory Proceduresplus icon
Science behind Tuberculosis Genotyping
Description of Genotyping Methods
Submission of Isolates
Genotyping Results, Designation of Clusters, and Reporting
Suspected False-Positive Cultures
IS*6110*-based RFLP Analysis
Combining Genotyping and Epidemiologic Data to Improve Our Understanding of TB Transmissionplus icon
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
Developing a Tuberculosis Genotyping Programplus icon
Developing a Written Plan
Initial Decisions
Establishing Procedures for:plus icon
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
Applying Genotyping Results to Tuberculosis Control Practicesplus icon
Evaluating Matching Genotypes
Evaluating Nonmatching Genotypes
Suspected False-Positive Culture Investigations
Expanded Contact Investigations
Outbreak Investigations
Cluster Investigations
Monitoring Trends
Appendicesplus icon
Appendix A: Glossary and Abbreviations
Appendix B: References and Useful Resourcesplus icon
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


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