Norkina O V, Kinsht V N, Mokrousov I V, Kurunov Iu N, Krasnov V A, Filipenko M L
Novosibirsk Research Institute for Bioorganic Chemistry, Russian Academy of Sciences, Siberia Branch, Novosibirsk, 630090, Lavrentyev Avenue, 8, Russia.
Mol Gen Mikrobiol Virusol. 2003(3):9-18.
Molecular epidemiology approaches provided for a new interpretation of the TB infection transmission dynamics, contributed to changing the focuses of attention and updated the monitoring practice. On the basis of 101 cases of isolates of Mycobacterium tuberculosis (MBT) complex sampled from 84 patients with pulmonary tuberculosis in the Siberian region, we proved that the independent methods of IS6110 RFLP genetic typing and VNTR-typing by five accurate repeat tandems of ETR A, B, C, D, and E bring about similar results and can be used in studying the MTB clonal structure population in the Siberian region for the purpose of defining the TB infection transmission dynamics. The most widespread genetic types were detected, i.e. Beeijing family strains, the S42 spoligotype, and the 31323 VNTR type, which account for 52.3% of all samples. The general parameters describing the epidemic process intensity were evaluated, i.e. those characterizing the strains (91.6%) and the transmission activity factor (72%). Consequently, each three of the four analyzed TB cases resulted from a recent transmission. However, there is a trend, within the analyzed samples, towards a higher percentage of clusterization in the age group ranging from 40 to 60. Such trend is typical of a prevalence of TB reactivation cases caused by MBT complex strains spread intensively in the discussed territory. As for the clusterized isolates, which are endemic for the territory, such data should be interpreted as a recent transmission only cautiously. 28.5% of the studied isolates are resistant to anti-TB drugs used in medical practice; and 35.7% of them are resistant to izoniazide and rifampicin, therefore, according to the WHO classification they are considered to be poly-antibiotics-resistant (PAR). No strict associations were found between the spectrum of antibiotics-resistance and any of genotypes, however, 30% of PAR strains are 32525 and 42525 types VNTR (spoligotype S1 or Beejing type).
分子流行病学方法为结核感染传播动态提供了新的解释，有助于改变关注重点并更新监测实践。基于从西伯利亚地区84例肺结核患者中采集的101株结核分枝杆菌（MBT）复合体分离株，我们证明，IS6110 RFLP基因分型和通过ETR A、B、C、D和E五个精确重复串联进行的VNTR分型这两种独立方法得出了相似结果，可用于研究西伯利亚地区MTB克隆结构群体，以确定结核感染传播动态。检测到了最广泛传播的基因类型，即北京家族菌株、S42间隔区寡核苷酸分型和31323 VNTR类型，它们占所有样本的52.3%。评估了描述流行过程强度的一般参数，即表征菌株的参数（91.6%）和传播活动因子（72%）。因此，每四例分析的结核病病例中有三例是近期传播所致。然而，在分析样本中，40至60岁年龄组的聚集率有上升趋势。这种趋势是由MBT复合体菌株在所述地区密集传播导致的结核再激活病例普遍存在的典型表现。至于该地区特有的聚集性分离株，此类数据仅应谨慎解释为近期传播。28.5%的研究分离株对医学实践中使用的抗结核药物耐药；其中35.7%对异烟肼和利福平耐药，因此，根据世界卫生组织的分类，它们被视为多重耐药（PAR）。在耐药谱与任何基因型之间未发现严格关联，然而，30%的PAR菌株是32525和42525类型VNTR（间隔区寡核苷酸分型S1或北京型）。
