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重庆地区耐多药结核分枝杆菌基因分型特征分析
Genotypic characteristics of multidrug-resistant
Mycobacterium tuberculosis in Chongqing- 第三军医大学学报 2017年39卷第12期 页码：1298-1303
- 作者机构：
1.400036 重庆，重庆市公共卫生医疗救治中心:检验科
2.400020 重庆，重庆市第十二人民医院检验科
3.400036 重庆，重庆市公共卫生医疗救治中心:耐多药结核病管理办公室
4.400036 重庆，重庆市公共卫生医疗救治中心:结核重点实验室
5.400036 重庆，重庆市公共卫生医疗救治中心:病案室
6.401120 重庆，重庆医科大学附属第三医院骨与创伤中心
- 作者简介：
[石涛，E-mail:shitaostone@163.comShi Tao, E-mail:shitaostone@163.com
- 基金信息：重庆市卫生局2012年医学科研重点项目(2012-1-085)
DOI：10.16016/j.1000-5404.201701077
中图分类号： R195.4;R372;R378.911收稿：2017-01-12，
修回：2017-02-11，
纸质出版：2017-06-30
- 稿件说明：
移动端阅览
李同心, 黄正谷, 王易伟, 等. 重庆地区耐多药结核分枝杆菌基因分型特征分析[J]. 第三军医大学学报, 2017,39(12):1298-1303.
Tongxin Li, Zhenggu Huang, Yiwei Wang, et al. Genotypic characteristics of multidrug-resistant
Mycobacterium tuberculosis in Chongqing[J]. Journal of Third Military Medical University, 2017, 39(12): 1298-1303.李同心, 黄正谷, 王易伟, 等. 重庆地区耐多药结核分枝杆菌基因分型特征分析[J]. 第三军医大学学报, 2017,39(12):1298-1303. DOI： 10.16016/j.1000-5404.201701077.
Tongxin Li, Zhenggu Huang, Yiwei Wang, et al. Genotypic characteristics of multidrug-resistant
Mycobacterium tuberculosis in Chongqing[J]. Journal of Third Military Medical University, 2017, 39(12): 1298-1303. DOI： 10.16016/j.1000-5404.201701077.
摘要
目的
2
对重庆地区耐多药结核患者结核分枝杆菌进行基因分型，明确该地区基因类型的特征和流行情况。
方法
2
连续收集重庆市公共卫生医疗救治中心和重庆市第十二人民医院结核内科2013年7月至2015年3月753例临床诊断为耐多药结核患者的痰液或其他体液，采用液体培养法分离培养分枝杆菌，采用PCR方法对分枝杆菌分离株进行菌种鉴定，并使用多位点数目可变串联重复序列分析(multiple locus variable number of tandem repeat analysis，MLVA)方法进行基因分型。采用Bionumerics Version 3.0和phyloviz软件进行各基因位点的多态性和成簇分析。
结果
2
共分离培养出538例耐多药分枝杆菌菌株，经PCR鉴定确认结核分枝杆菌有503例(95.8%)，非结核分枝杆菌有35例(4.2%)。北京家族型470例(93.4%，470/503)，非北京家族型33例(6.6%，33/503)。503例分枝杆菌菌株共分为348个基因型，其中267例患者分离株为单一基因型，其余236例菌株可归入81个簇，成簇率为30.8%。北京家族型有76个簇，成簇率为30.8%，成簇比例为35.9%，非北京家族型有5个簇，成簇率为30.3%，成簇比例为33.3%。不同特征的耐多药结核人群对结核分枝杆菌北京基因型菌株易感因素分析：感染北京基因型菌株与性别无显著性关联(χ
2
=2.68
P
>
0.05)；与年龄呈显著性关联(χ
2
=784.00
P
<
0.05)。
结论
2
重庆地区耐多药结核分枝杆菌的基因型存在明显的多态性，北京基因型占绝对优势；不同特征耐多药结核人群感染北京基因型菌株与性别无关
与年龄相关。
Abstract
Objective
2
To investigate the genotypic characteristics and prevalence of multidrug-resistant
Mycobacterium tuberculosis
in Chongqing.
Methods
2
This retrospective study was conducted among 753 patients with a clinical diagnosis of multidrug-resistant tuberculosis
who received treatments in the Public Health Medical Center and the 12th People' s Hospital of Chongqing from July
2013 to March
2015. Mycobacterial strains were isolated from the sputum or other body fluid samples from the patients and cultured using the liquid culture method. The isolates of
Mycobacterium tuberculosis
were tested with PCR and genotyped using multiple-locus variable-number tandem repeat analysis (MLVA). Bionumerics Version 3.0 and Phyloviz software was used to analyze the polymorphisms and clustering of the genetic loci.
Results
2
A total of 538 multidrug-resistant mycobacterial strains were isolated and identified
including 503 (95.8%) strains of
Mycobacterium tuberculosis
and 35 (4.2%) strains of other species. Of the 503 strains of
Mycobacterium tuberculosis
470 (93.4%
470/503) were of the Beijing family genotype and 33 (6.6%
33/503) were of other genotypes. A total of 348 genotypes were identified among the 503 mycobacterial strains; 267 strains had a single genotype while the remaining 236 strains were classified into 81 clusters with a clustering rate of 30.8%. The strains of Beijing family genotype had 76 clusters with a clustering rate of 30.8% and a clustering ratio of 35.9%. Five clusters were identified among the strains with non-Beijing family genotypes with a clustering rate of 30.3% and a clustering ratio of 33.3%. Vulnerability analysis showed that the infection with
Mycobacterium tuberculosis
of Beijing family genotype was significantly correlated with the patients'age (
Chi
s
quare=784.00
P
<
0.05) but not with their gender (
Chi
square=2.68
P
>
0.05).
Conclusion
2
The multidrug-resistant
Mycobacterium tuberculosis
strains isolated from Chongqing have polymorphic genotypes
among which the Beijing family genotype is predominant. The vulnerability to infections by multidrug-resistant
Mycobacterium tuberculosis
of Beijing family genotype is related with age but not with gender.
关键词
Keywords
references
[World Health Organization. Global tuberculosis report 2015[EB/OL ] .[2017-01-12 ] . http://www.tbonline.info/posts/2015/10/28/global-tuberculosis-report-2015/ http://www.tbonline.info/posts/2015/10/28/global-tuberculosis-report-2015/ .
Maurya A K, Kant S, Nag V L, et al. Trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of extrapulmonary tuberculosis cases in referral hospitals in northern India[J]. J Postgrad Med, 2012, 58(3): 185-189. DOI: 10.4103/0022-3859.101379.
Su rez-Garc a I, Noguerado A. Drug treatment of multidrug-resistant osteoarticular tuberculosis: a systematic literature review[J]. Int J Infect Dis, 2012, 16(11): e774-e778. DOI: 10.1016/j.ijid.2012.07.011.
Duo L, Ying B, Song X, et al. Molecular profile of drug resistance in tuberculous meningitis from southwest china[J]. Clin Infect Dis, 2011, 53(11): 1067-1073. DOI: 10.1093/cid/cir663.
Falzon D, Jaramillo E, Schunemann H J, et al. WHO guidelines for the programmatic management of drug-resistant tuberculosis: 2011 update[J]. Eur Respir J, 2011, 38(3): 516-528. DOI: 10.1183/09031936.00073611.
卫生部疾病预防控制局.中国结核病防治规划实施工作指南(2008年版)[M].北京:中国协和医科大学出版社, 2009.
Bureau of Disease Control and Prevention of Ministry of Health of China. Guidelines for the implementation of tuberculosis control programs in China (2008 edition) [M]. Beijing: China Union Medical University Press, 2009.
Mitnick C D, Rodriguez C A, Hatton M L, et al. Programmatic management of drug-resistant tuberculosis: an updated research agenda[J]. PLoS One, 2016, 11(5): e0155968. DOI: 10.1371/journal.pone.0155968.
唐神结, 许绍发, 李亮.耐药结核病学[M].北京:人民卫生出版社, 2014.
Tang S J, Xu S F, Li L. Drug-resistant tuberculosis [M]. Beijing: People's Health Publishing House, 2014.
中国防痨协会基础专业委员会.结核病诊断实验室检验规程[M].北京:中国教育文化出版社, 2006.
China Anti-tuberculosis Association Basic Professional Committee. Tuberculosis diagnostic laboratory test procedure[M]. Beijing: China Education and Culture Press, 2006.
赵雁林.分枝杆菌分离培养标准化操作程序及质量保证手册[M].北京:人民卫生出版社, 2013.
Zhao Y L. Standardization procedure and quality assurance manual for isolation and culture of mycobacteria [M]. Beijing: People's Health Publishing House, 2013.
赵雁林, 刘宇红, 姜广路, 等.中国结核病防治规划:痰涂片镜检标准化操作及质量保证手册[M].北京:中国协和医科大学出版社, 2009.
Zhao Y L, Liu Y H, Jiang G L, et al. China tuberculosis control program: sputum patch mirror standardization operation and quality assurance manual [M]. Beijing: China Union Medical College Press, 2009.
Luo T, Yang C, Pang Y, et al. Development of a hierarchical variable-number tandem repeat typing scheme for Mycobacterium tuberculosis in china[J ] . PLoS One, 2014, 9(2): e89726. DOI: 10.1371/journal.pone.0089726.
Hunter P R, Gaston M A. Numerical index of the discriminatory ability of typing systems: an application of Simpson's index of diversity[J]. J Clin Microbiol, 1988, 26(11): 2465-2466.
Park Y K, Shin S, Ryu S, et al. Comparison of drug resistance genotypes between Beijing and non-Beijing family strains of Mycobacterium tuberculosis in Korea[J ] . J Microbiol Methods, 2005, 63(2): 165-172. DOI: 10.1016/j.mimet.2005.03.002.
Ghebremichael S, Groenheit R, Pennhag A, et al. Drug resistant Mycobacterium tuberculosis of the Beijing genotype does not spread in Sweden[J ] . PLoS One, 2010, 5(5): e10893. DOI: 10.1371/journal.pone.0010893.
Mokrousov I, Jiao W W, Sun G Z, et al. Evolution of drug resistance in different sublineages of Mycobacterium tuberculosis Beijing genotype[J ] . Antimicrob Agents Chemother, 2006, 50(8): 2820-2823. DOI: 10.1128/AAC.00324-06.
Zhao M, Li X, Xu P, et al. Transmission of MDR and XDR tuberculosis in Shanghai, China[J]. PLoS One, 2009, 4(2): e4370. DOI: 10.1371/journal.pone.0004370.
Liu Y, Tian M, Wang X, et al. Genotypic diversity analysis of Mycobacterium tuberculosis strains collected from beijing in 2009, using spoligotyping and VNTR typing[J ] . PLoS One, 2014, 9(9): e106787. DOI: 10.1371/journal.pone.0106787.
Chen Y Y, Chang J R, Kuo S C, et al. Molecular epidemiology of tuberculosis in Kaohsiung city located at southern Taiwan, 2000-2008[J]. PLoS One, 2015, 10(1): e0117061. DOI:10.1371/journal.pone.0117061.
Wang Q, Lau S K, Liu F, et al. Molecular epidemiology and clinical characteristics of drug-resistant Mycobacterium tuberculosis in a tuberculosis referral hospital in China[J ] . PLoS One, 2014, 9(10): e110209. DOI: 10.1371/journal.pone.0110209.
Chan M Y, Borgdorff M, Yip C W, et al. Seventy percent of the Mycobacterium tuberculosis isolates in Hong Kong represent the Beijing genotype[J ] . Epidemiol Infect, 2001, 127(1): 169-171.
王胜芬, 周杨, 逄宇, 等.结核分枝杆菌北京基因型菌株的流行特征及其与耐药的关系—2007年全国结核病耐药基线调查资料分析[J].中国防痨杂志, 2015, 37(8): 836-842. DOI: 10.3969/j.issn.1000-6621.2015.08.008.
Wang S F, Zhou Y, Pang Y, et al. Epidemic characteristics of Mycobacterium tuberculosis of Beijing genotype strains and its association with drug resistance—Analysis of the data from national drug resistant tuberculosis baseline survey in 2007[J ] . Chin J Antitubercul, 2015, 37(8): 836-842. DOI: 10.3969/j.issn.1000-6621.2015.08.008.
Luo T, Yang C, Gagneux S, et al. Combination of single nucleotide polymorphism and variable-number tandem repeats for genotyping a homogenous population of Mycobacterium tuberculosis beijing strains in china[J ] . Journal of Clinical Microbiology, 2011, 50(3): 633-639. DOI: 10.1128/jcm.05539-11.
Guo J H, Xiang W L, Zhang G, et al. Mycobacterial Interspersed Repetitive Unit typing in Mycobacterium tuberculosis isolates from Sichuan Province in China[J ] . Indian J Med Res, 2011, 134: 362-368.
Pang Y, Zhou Y, Zhao B, et al. Spoligotyping and drug resistance analysis of Mycobacterium tuberculosis strains from national survey in China[J ] . PLoS One, 2012, 7(3): e32976. DOI: 10.1371/journal.pone.0032976.
Liu Q, Yang D, Xu W, et al. Molecular typing of Mycobacterium tuberculosis isolates circulating in Jiangsu province, China[J ] . BMC Infect Dis, 2011, 11: 288. DOI: 10.1186/1471-2334-11-288.
Dong H, Shi L, Zhao X, et al. Genetic diversity of Mycobacterium tuberculosis isolates from Tibetans in Tibet, China[J ] . PLoS One, 2012, 7(3): e33904. DOI: 10.1371/journal.pone.0033904.
Wang J, Liu Y, Zhang C L, et al. Genotypes and characteristics of clustering and drug susceptibility of Mycobacterium tuberculosis isolates collected in Heilongjiang province, China[J ] . J Clin Microbiol, 2011, 49(4): 1354-1362. DOI: 10.1128/jcm.02274-10.
Kam K M, Yip C W, Tse L W, et al. Utility of mycobacterial interspersed repetitive unit typing for differentiating multidrug-resistant Mycobacterium tuberculosis isolates of the Beijing family[J ] . J Clin Microbiol, 2005, 43(1): 306-313. DOI: 10.1128/JCM.43.1.306-313.2005.
Zheng C, Zhao Y, Zhu G, et al. Suitability of IS6110-RFLP and MIRU-VNTR for differentiating spoligotyped drug-resistant Mycobacterium tuberculosis clinical isolates from Sichuan in China[J ] . Biomed Res Int, 2014, 2014: 763204. DOI: 10.1155/2014/763204.
Zhang D, An J, Wang J, et al. Molecular typing and drug susceptibility of Mycobacterium tuberculosis isolates from Chongqing Municipality, China[J ] . Infect Genet Evol, 2013, 13: 310-316. DOI: 10.1016/j.meegid.2012.10.008.
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