Urgent implementation in a hospital setting of a strategy to rule out secondary cases caused by imported XDR tuberculosis at diagnosis. TB-ASOPCR

The current migratory movements demmand to define new strategies to rapidly track the transmission of high-risk Mycobacterium tuberculosis (MTB) imported strains. Whole genome sequencing allows us to identify strain-specific SNPs for any strain to design strain- specific PCRs to track them. However, fast implementing of these strategies at the hospital setting is difficulted because professionals dealing with diagnostics, molecular epidemiology and genomics are generally split in independent institutions. In this study we present the urgent implementation of a system integrating genomics and molecular tools in a true high- risk epidemiological alert: two independent importation of XDR Beijing MTB strains from Russia into Spain. This system based on strain-specific PCRs tailored from WGS data allowed to prospectively rule out at diagnosis transmission caused by these strain.