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Escherichia coli Cluster Evaluation

机译：大肠杆菌群评价

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To the Editor: Gupta et al. raiseimportant issues regarding molecularprofiling as an epidemiologic tool (1).First, since all living organisms arerelated, the goal of genomic profilingin public health epidemiology is notreally to determine "whether such iso-lates are truly related" (1) (they are),but to define the degree of similari-ty—or, more specifically, to deter-mine whether isolates are sufficientlyclosely related that the probability oftheir deriving immediately from thesame point source is high enough towarrant epidemiologic investigation.Second, definitive assessment ofgenetic similarity relationships ischallenging because of the limitedaccuracy and resolving power of con-ventional methods such as pulsed-field gel electrophoresis (PFGE)analysis (2) and the impracticality andexpense of better performing tech-nologies. Sequential use of multiplemethods (such as PFGE with addi-tional restriction enzymes) will pre-dictably detect additional differences,thereby improving resolving power(2). Third, even if genetic similaritycould be precisely defined, the rela-tionship between the degree of genet-ic similarity and the probability ofpoint-source spread is unknown anddoubtless varies in relation to pretestprobability, depending on the epi-demiologic context (e.g., localized vs.multistate clusters). Even <100% sim-ilarity may be compatible with point-source spread when genetic driftexists within the reservoir, leading todissemination of highly similar butnonidentical clones
机译：致编辑：Gupta等。提出了将分子谱分析作为流行病学工具的重要问题。（1）首先，由于所有活生物体都相关，因此公共卫生流行病学中基因组谱分析的目标并不是要确定“这些分离物是否真正相关”（1）（有），但要定义相似度，或更确切地说，是确定那些分离株是否足够紧密地相关，以使它们从同一点源直接获得的可能性足够高，以致于需要流行病学调查。第二，对遗传相似性关系的确定性评估具有挑战性，因为传统方法（如脉冲场凝胶电泳（PFGE）分析（2））的有限精度和分辨力，以及性能更好的技术的不切实际和昂贵。顺序使用多种方法（例如带有额外限制性酶的PFGE）可以预测发现其他差异，从而提高分离能力（2）。第三，即使可以精确地定义遗传相似性，遗传相似性程度与点源传播概率之间的关系还是未知的，并且与前测概率有关毫无疑问，这取决于流行病学背景（例如局部.multistate群集）。当遗传漂移存在于储层中时，即使<100％的相似性也可能与点源传播兼容，从而导致高度相似但不完全相同的克隆的传播

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