Abstract Background Tuberculosis (TB) in children is often an indicator of recent transmission. Genotyping and whole genome sequencing (WGS) can enhance pediatric TB investigations by confirming or refuting transmission events. Methods Mycobacterium tuberculosis isolates from all pediatric patients <18 years with culture-confirmed TB in British Columbia (BC) from 2005–2014 (n=49) were genotyped by MIRU-VNTR and compared to adult isolates. Genotypically clustered cases underwent WGS. Clinical, demographic and contact data were reviewed for each case. Results Twenty-three children were Canadian-born, seven to Canadian-born parents (CBP) and 16 to foreign-born parents (FBP). Of the 26 foreign-born children, all were born in Asia (81%) or Africa (19%). Using molecular and epidemiological data, we determined that 15 children had acquired their infection within BC, and household transmission explained all seven Canadian-born (FBP) children that acquired TB locally. In contrast, six of seven Canadian-born (CBP) children were exposed via a non-household community source. Eight Canadian-born (FBP) children acquired their infections through travel to their parents’ place of birth. All but one of the foreign-born children acquired their infection outside of BC. Conclusions Genotyping and genomic data reveal that drivers of pediatric transmission vary according to a child’s age, birthplace, and their parents’ place of birth. pediatric, tuberculosis, genomic epidemiology, transmission © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
The Journal of Infectious Diseases – Oxford University Press
Published: May 11, 2018
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