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Table 2 Required Discriminatory Power and Need to Infer Genetic Relationships and/or Population Structure for Various Epidemiologic Applications of Bacterial Typing Techniques

From: Choosing an appropriate bacterial typing technique for epidemiologic studies

Purpose

Example Research Goal

Discriminatory Power Needed

Need to infer genetic relationships and/or population structure

Confirm epidemiologic linkage

a. Determine if epidemiologically related cases share the identical organism. Result: either support or refute epidemiologic data.

Low

Low

Generate hypotheses about epidemiologic relationships between bacterial strains in the absence of epidemiologic data

a. Determine if time-space clustering surveillance isolates have identical or related genetic types. Result: trigger further epidemiologic investigation of related isolates.

b. Determine if outbreak is propagated. Result: trigger investigation into how is spread and/or control actions to stop spread.

c. Relate clinical outcomes to strain types or to the presence of transferable genetic material, e.g., antimicrobial resistance on a plasmid. Result: improve patient care.

Moderate to High

Moderate

Describe distribution of bacterial types and identify the determinants of that distribution

a. Test the hypothesis of clonal spread versus independent origin of a particular strain over disparate geographic areas. Result: Better predict emergence and spread of disease.

b. Determine flow of infection from one group to another. Result: Public health intervention

c. Identification of pathogenic factors. Result: Develop new interventions or therapies specific to those factors

Moderate to High

High