Title: Associate Professor of Medicine, UF Division of Infectious Diseases and Global Medicine; Deputy Director of the Emerging Pathogens Institute; Director of University of Florida’s SNTC program.
Research Interests: Latent Tuberculosis (TB) treatment, Molecular epidemiology of TB, Global health, and TB treatment
Molecular Epidemiology of Tuberculosis
Molecular epidemiology using spacer oligonucleotide typing (Spoligotyping), mycobacterial interspersed repetitive units variable number tandem repeats (MIRU-VNTR) and whole genome sequencing) have been instrumental to the detection of Mycobacterium tuberculosis complex (MTBC) outbreaks in the community by classifying strains into clusters of isolates with identical genotype patterns, with clustering serving as a proxy measure for transmission. Our lab is working to better define how these tools can best be used to identify and intervene in TB outbreaks.
Tuberculosis Epidemiology of Tuberculosis
The Tuberculosis Epidemiologic Studies Consortium, or TBESC, study is a multi-site collaborative effort funded and directed by the CDC. Our group is one of ten sites in the United States. In recent years, the U.S. has recorded the lowest TB rates in history. One factor that has contributed to this decline is a strong scientific approach to TB control. To accelerate the decline and achieve the goal of TB elimination, research is needed for improved diagnostic tools, treatments, and approaches. Preventing TB disease by detecting and treating those with latent TB infection is a cornerstone of the U.S. strategy for TB elimination. It is estimated that more than 11 million people in the U. S. have latent TB infection; however, most of these people are unaware of their infection. If not treated, about 5 to 10 percent of people with latent TB infection will develop TB disease. This equates to approximately 550,000 to 1.1 million people in the U.S. diagnosis and treatment of latent TB infection can be difficult with existing diagnostic tools and treatment regimens. This is a prospective cohort study of persons tested for latent tuberculosis infection (LTBI) who are at either high risk for exposure to M. Tuberculosis or high risk for progression to TB disease. The study will assess the relative performance and cost of three diagnostic tests for LTBI (Tuberculin Skin Test (TST), QuantiFERON – TB Gold In-Tube test (QFT), and T-SPOT.TB test) and will examine the rates of positive results among the cohort. The study will also determine the risk and rate of progression to active TB disease, overall and by the results of the three tests.
The primary objectives of the TBESC study:
- Evaluates tests used to detect latent TB infection. These tests include the tuberculin skin test (TST) and the interferon-gamma release assays (IGRAs): QuantiFERON®-TB Gold In-Tube (QFT-GIT), and T-SPOT®.TB test (T-Spot).
- Compares the ability of the TST and IGRAs to predict progression from latent TB infection to TB disease. This study is one of the largest of its kind. Approximately 6,000 patients will be enrolled each year for a total enrollment of about 42,000 patients over a 7-year period.
TBESC study will also evaluate:
- Strategies to ensure latent TB infection treatment acceptance and completion.
- Shorter, safer, and cost-effective latent TB infection treatment regimens.
- Michael Lauzardo, MD, MSc – Principal Investigator
- Nancy Marie Seraphin, MPH, PhD – Co-Investigator
- Stephanie Bigby, MPH – Clinical Research Coordinator, South Florida