Evidence map›Paper›PMID 34632432›Full record

Observational studyThe Lancet. Microbe2021

Epidemiology of

Samuel Lipworth, Natasha Hough, Natasha Weston, Berit Muller-Pebody, Nick Phin, Richard Myers, Stephen Chapman, William Flight, Eliza Alexander, E Grace Smith and 7 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in The Lancet. Microbe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 34 citations in OpenAlex.

  1. Genetic analysis ofiScience · 2026
    Article
  2. Article
  3. Infection by Clonally RelatedAmerican journal of respiratory and critical care medicine · 2025
    Article
  4. Macrolide resistance inJAC-antimicrobial resistance · 2025
    Review
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Population genetic analysis of clinicalFrontiers in cellular and infection microbiology · 2024
    Article
  11. Article
  12. Article
  13. Mutation rates and the molecular epidemiology ofProceedings of the National Academy of Sciences of the United States of America · 2023
    Article
  14. Mutation rates and adaptive variation among the clinically dominant clusters ofProceedings of the National Academy of Sciences of the United States of America · 2023
    Article
  15. The European respiratory journal · 2023
    Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 4 institutions in 2 countries.

Samuel LipworthNuffield Department of Medicine, University of Oxford, Oxford, UK.
Natasha HoughOxford University Hospitals NHS Foundation Trust, Oxford, UK.
Natasha WestonNational Mycobacterial Reference Service-Central and North, Public Health England, Public Health Laboratory, Birmingham, UK.
Berit Muller-PebodyTuberculosis, Acute Respiratory, Gastrointestinal, Emerging and Zoonotic Infections and Travel Migrant Health Division, National Infection Service, Public Health England, London, UK.
Nick PhinTuberculosis, Acute Respiratory, Gastrointestinal, Emerging and Zoonotic Infections and Travel Migrant Health Division, National Infection Service, Public Health England, London, UK.
Richard MyersTuberculosis, Acute Respiratory, Gastrointestinal, Emerging and Zoonotic Infections and Travel Migrant Health Division, National Infection Service, Public Health England, London, UK.
Stephen ChapmanOxford University Hospitals NHS Foundation Trust, Oxford, UK.
William FlightOxford University Hospitals NHS Foundation Trust, Oxford, UK.
Eliza AlexanderNational Mycobacterial Reference Service-South, Public Health England, London, UK.
E Grace SmithNational Mycobacterial Reference Service-Central and North, Public Health England, Public Health Laboratory, Birmingham, UK.
Esther RobinsonNational Mycobacterial Reference Service-Central and North, Public Health England, Public Health Laboratory, Birmingham, UK.
Tim E A PetoNuffield Department of Medicine, University of Oxford, Oxford, UK.
Derrick W CrookNuffield Department of Medicine, University of Oxford, Oxford, UK.
A Sarah WalkerNuffield Department of Medicine, University of Oxford, Oxford, UK.
Susan HopkinsTuberculosis, Acute Respiratory, Gastrointestinal, Emerging and Zoonotic Infections and Travel Migrant Health Division, National Infection Service, Public Health England, London, UK.
David W EyreBig Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Timothy M WalkerOxford University Hospitals NHS Foundation Trust, Oxford, UK.
Public Health England · GBUniversity of Oxford · GBOxford University Hospitals NHS Trust · GBOxford University Clinical Research Unit · VN

Funding

Medical Research Council MR/T001151/1Wellcome Trust
6 · The paper itself

Abstract

background

methodsIn this retrospective observational study, we analysed consecutive

findings2297 isolates from 906 patients underwent whole-genome sequencing as part of the routine Public Health England diagnostic service. Of 14 genomic clusters containing isolates from ten or more patients, all but one contained patients with cystic fibrosis and patients without cystic fibrosis. Patients with cystic fibrosis were equally likely to have clustered isolates (258 [60%] of 431 patients) as those without cystic fibrosis (322 [63%] of 513 patients; p=0·38). High-density phylogenetic clusters were randomly distributed over a wide geographical area. Most isolates with a closest genetic neighbour consistent with potential transmission had no identifiable relevant epidemiological contacts. Having a clustered isolate was independently associated with increasing age (adjusted odds ratio 1·14 per 10 years, 95% CI 1·04-1·26), but not time spent as an hospital inpatient or outpatient. We identified two sibling pairs with cystic fibrosis with genetically highly divergent isolates and one pair with closely related isolates, and 25 uninfected presumed household contacts with cystic fibrosis.

interpretationPreviously identified widely disseminated dominant clones of

fundingThe National Institute for Health Research, Health Data Research UK, The Wellcome Trust, The Medical Research Council, and Public Health England.

Indexed as

Cystic FibrosisMycobacterium abscessusMycobacterium Infections, NontuberculousChildHumansPhylogenyWhole Genome Sequencing

Identifiers

PMID34632432
PMCPMC8481905
OpenAlexW3162945274

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.