Frances Jamieson

Dr. Jamieson obtained her MD from the University of Toronto in 1984.  She trained in anatomic pathology and medical microbiology at the University of Toronto, and received her Fellowship from the Royal College of Physicians and Surgeons in Medical Microbiology in 1991.  Dr. Jamieson was a Federal Field Epidemiologist and Staff Medical Microbiologist at the Hospital for Sick Children prior to joining the Public Health Laboratories (now part of Public Health Ontario) in 1996, where Dr. Jamieson was the Associate Medical Director and Medical Director (Acting) from 2010 - 2013.  She holds an appointment as Associate Professor and Graduate Faculty, Dept. of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, and as assistant scientific staff, Dept of Microbiology, Mount Sinai Hospital. 

Dr. Jamieson has been involved in and managed several large outbreaks, including SARS. She has received the Ontario Ministry of Health and Long-Term Care ACE award for outstanding achievement in 2001, 2002, 2004, and 2005, was nominated for the John G. Fitzgerald Outstanding Microbiologist Award in 2013.  She received the National LEADing Practice award from Canada Health Infoway and Accreditation Canada in 2014 for her conception and development of the Ontario Universal Typing-Tuberculosis application (OUT-TB Web), an online platform for enhanced TB surveillance that provides near-time comprehensive genotype and epidemiological data in an actionable, user-friendly and usable format for the end-user.

Dr. Jamieson has over 170 peer-reviewed publications, and has served on a large number of international, national, provincial and Public Health Ontario committee.  After three years as the provincial co-chair for the Canadian Public Health Laboratory Network (CPHLN), she remains with the CPHLN executive as (past) provincial co-chair. 

At the PHOL, Dr. Jamieson is responsible for the tuberculosis and mycobacteriology laboratory as well as bacterial vaccine-preventable diseases (except for S. pneumonia), laboratory surveillance and data management, and emergency response.

Her primary areas of interest include tuberculosis and mycobacterial diseases, meningococcal disease, molecular surveillance of pathogens of public health importance, and public health policy.

Research Synopsis

My research is focused on the molecular epidemiology and genomics, and determinants of resistance and virulence in  M. tuberculosis strains and non-tuberculosis mycobacteria (NTM).  Research initiatives have been undertaken using comparative genomics and strain characterization (e.g. LSPs and SNPs) to recognize and identify virulence factors associated with local, circulating strains of M. tuberculosis.

More than one-third of all new TB cases diagnosed annually in Canada originate in Ontario, with an incidence rate of 4.6/100,000 (2013 data), with the Canadian rate at 4.7/100,000 (2013 data). 

Under the direction of Dr. Frances Jamieson, the TB and Mycobacteriology laboratory of the Public Health Ontario Laboratories provides both diagnostic and reference laboratory services for the Province of Ontario, and is the largest laboratory of its kind in North America. A recent grant-funded initiative saw the development and implementation of rapid PCR-based genotyping methods for typing of tuberculosis isolates, and the provision of this information in a usable and user-friendly format to public health TB control by the development and implementation of a web-based, Geographic Information System (GIS), known as Ontario Universal Typing – Tuberculosis (OUT-TB).  The prospective genotyping and communication utilizing the OUT-TB tool and other mechanisms, has resulted in the improvement of TB case investigation and identification of previously unrecognized transmission, as well as the development of a comprehensive genotyping database. 

This laboratory and clinical/epidemiological linked database has and is currently being utilized as a base for the surveillance of M. tuberculosis in Ontario, and research initiatives such as comparative genomics and strain characterization (e.g. Large Sequence Polymorphisms (LSPs) and Single Nucleotide Polymorphisms (SNPs) to recognize and identify virulence factors associated with local, circulating strains.

Ontario has a very heterogeneous population, and comparative genomics and generated lineage trees demonstrate that there is a strain unique to Toronto seen within the under-housed and socially disadvantaged populations. It is postulated that this strain has adapted over several years to this particular socio-economically disadvantage group, and further investigations are underway, including the analysis of Whole Genome Sequencing with the potential for identifying mutations that may account for the apparent clinical hypervirulence of this strain. 

Genome data will also inform lipidomic and proteomic studies and investigations into the microevolution of this strain. The database has also facilitated several collaborations to determine the extent of mycobacterial disease in specific patient populations in Ontario.

Improved diagnostics assays for the detection of drug resistance in tuberculosis are critical. The laboratory is involved in research initiatives for the standardization of phenotypic assays in Canada for second-line drug susceptibility testing, and the molecular determinants of drug resistance in M. tuberculosis isolates seen in Ontario. Sequencing and other novel/improved methods assays are under investigation or being developed for the detection of new mutations and their association (or lack of) with full phenotypic expression.  

More than 50% of all isolates obtained from diagnostic specimens submitted for mycobacterial culture are non-tuberculous mycobacteria (NTM) in Ontario.  NTM are increasingly being recognized as a significant health problem, particularly in an aging population. 

In Ontario, the rates of NTM isolation have increased at 8% per year. The TB and Mycobacteriology laboratory regularly collaborates with clinical colleagues in the investigation of NTM disease and epidemiology in Ontario, and has recently undertaken a comprehensive clinical, epidemiological and microbiological study of M. xenopi, the most commonly isolated NTM in Ontario after M. avium complex, utilizing comparative genomics and other tools, on local clinical and environmental strains, and other strains from similar environmental regions. 

Dr. Jamieson is collaborating with external clinical investigators and the Institute for Clinical Evaluative Sciences in the investigation of risk factors associated with NTM and TB disease in Ontario using the comprehensive laboratory database, public health data and administrative databases.  Grant funding has been obtained in support of these studies.  Other initiatives include the investigation and implementation of rapid species and sub-species identification for clinical case management, detection of drug resistance by phenotypic and molecular methods, and the development of genotyping systems for clinically important NTM.

Recent Publications

Selected List of Publications:

Marras TK, Campitelli MA, Kwong JC, Lu H, Brode SK, Marchand-Austin A, Gershon AS, Jamieson FB. Risk of nontuberculous mycobacterial pulmonary disease with obstructive lung disease. European Respiratory Journal. 2016 Mar. In Press.

Duncan C, Jamieson F, Mehaffy C. Preliminary evaluation of exome sequencing to identify genetic markers of susceptibility to tuberculosis disease. BMC Res Notes. 2015 Dec 8;8:750.

Mehaffy C, Guthrie JL, Alexander DC, Stuart R, Rea E, Jamieson FB. Marked Microevolution of a Unique Mycobacterium tuberculosis Strain in 17 Years of Ongoing Transmission in a High Risk Population. PLoS One. 2014 Nov 18;9(11):e112928

Jamieson FB, Teatero S, Guthrie JL, Neemuchwala A, Fittipaldi N and Mehaffy C. Erratum for Jamieson et al., Whole-Genome Sequencing of the Mycobacterium tuberculosis Manila Sublineage Results in Less Clustering and Better Resolution than Mycobacterial Interspersed Repetitive-Unit-Variable-Number Tandem-Repeat (MIRU-VNTR) Typing and Spoligotyping. J Clin Microbiol. 2015 Feb. 2015 Feb;53(2):754. doi: 10.1128/JCM.03501-14.

Jamieson FB, Guthrie JL, Neemuchwala A, Lastovetska O, Melano RG, Mehaffy C. Profiling of rpoB mutations and MICs for rifampin and rifabutin in Mycobacterium tuberculosis. J Clin Microbiol. 2014 Jun;52(6):2157-62

Alexander DC, Marras TK, Ma JH, Mirza S, Liu D, Kus JV, Soualhine H, Escuyer V, Warshauer D, Brode SK, Farrell DJ, Jamieson FB. Multilocus sequence typing of Mycobacterium xenopi. J Clin Microbiol. 2014 Nov;52(11):3973-7

Brode SK, Jamieson FB, Ng R, Campitelli MA, Kwong JC, Paterson JM, Li P, Marchand-Austin A, Bombardier C, Marras TK. Increased risk of mycobacterial infections associated with anti-rheumatic medications. Thorax. 2015 Apr 24

Brode SK, Jamieson FB, Ng R, Campitelli MA, Kwong JC, Paterson JM, Li P, Marchand-Austin A, Bombardier C, Marras TK. Risk of mycobacterial infections associated with rheumatoid arthritis in ontario, Canada. Chest. 2014 Sep;146(3):563-72

Marras TK, Mendelson D, Marchand-Austin A, May K, Jamieson FB. Pulmonary nontuberculous mycobacterial disease, Ontario, Canada, 1998-2010. Emerg Infect Dis. 2013 Nov;19(11):1889-91