Determining the route or mode of transmission of pathogenic microorganisms is paramount
to controlling any outbreak situation, whether it occurs in the hospital or in public
health environment. To help accomplish this, oftentimes the clonality or relatedness
of microorganisms is assessed. The basic question posed to the molecular epidemiologist
is whether “strain A is related to strain B.” Before the advent of molecular techniques,
imprecise phenotypic characteristics were exploited, such as antimicrobial susceptibility
testing or other variable attributes. Currently, multiple molecular techniques have
been designed to examine questions of clonality. Due to the plasticity of the genome,
most pathogenic bacteria have a great deal of genetic diversity that is due mainly
to the acquisition (and loss) of bacteriophage, pathogenicity islands, plasmids, and
other genetic elements. It is this genetic diversity that makes it possible to use
these molecular methods to differentiate strains of the same species. The main hypothesis
of molecular epidemiology is the following: within the “epidemiologic window” [
[1]
], the isolates being considered will have either indistinguishable characteristics
(ie, the same genetic fingerprint) and thus be considered clonally related (same strain),
or the isolates will have distinguishable characteristics and be considered different
strains. However, in clinical situations, the data that is received regarding strain
typing is not always straightforward and must be considered in the context of the
epidemiologic circumstances. This article focuses on the methods used in molecular
epidemiology and the current concepts with regard to how data are interpreted to help
answer epidemiologic questions in both the nosocomial and public health environment.To read this article in full you will need to make a payment
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