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For this analysis we excluded those "mixed" clusters with immigrants and their children born in Germany.
We observed a trend to mixed clusters with increasing time spent by immigrants in the host country.
Mixed clusters with a German index case support, once again, our conclusion that the effect of imported TB on transmission into the autochthonous population is lower than expected.
There were a total of 28 multinational clusters (composed of cases from 2 to 4 different countries), of which 16 were mixed clusters (with Germans and immigrants) and 12 were immigrant clusters.
Momeni et al. found that as long as there was space for the yeast cells to grow into, the two species that cooperated self-organized into mixed clusters, with the cheating species being excluded from these clusters.
5) Haarlem genotype: cluster 12 and 45 are mixed clusters with a German and a Bosnian and a German and Yugoslavian (three countries where this genotype is endemic) with no epidemiological information available linking the members of these clusters.
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Cluster 35 is a mixed cluster with two immigrants and one German, with one of the immigrants and the German presenting the same Multi-Drug Resistance (MDR) pattern.
3) Delhi genotype: cluster 43 is a mixed cluster with an immigrant from Nepal (where this genotype is endemic) and a German.
There was a clear division between the coastal ocean and river sediment samples along PC1, whereas the estuary, freshwater lake, and WWTP effluent formed a mixed cluster with neutral scores along PC1.
This mixed cluster with two immigrants and one German case could represent recent transmission in Germany (see the identical DST pattern of the German and one of the immigrant isolates).
3) Although only one of the selected Delhi clusters was confirmed through contact investigations, we believe both clusters illustrate recent transmission in Germany: cluster 43 is a mixed cluster with an immigrant from a high-endemic country (Nepal) showing a high integration index and a German.
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