Brudey Karine, Gordon Max, Moström Peter, Svensson Liselott, Jonsson Bodil, Sola Christophe, Ridell Malin, Rastogi Nalin
Unité de la Tuberculose et des Mycobactéries, Institut Pasteur de Guadeloupe, Morne Jolivière, BP 484, 97165 Pointe-à-Pitre, Cedex, Guadeloupe.
J Clin Microbiol. 2004 Jul;42(7):3046-51. doi: 10.1128/JCM.42.7.3046-3051.2004.
The genetic diversity of Mycobacterium tuberculosis isolates among patients from Sweden was determined by a combination of two PCR-based techniques (spoligotyping and variable number of tandem repeats analysis). It resulted in a clustering of 23.6% of the isolates and a rate of recent transmission of 14.1%. The clustered isolates mainly belonged to the Haarlem family (23.2%), followed by the Beijing (9.8%), Latin American and Mediterranean (LAM; 8%), and East African-Indian (EAI; 6.2%) families. A comparison of the spoligotypes with those in the international spoligotyping database showed that 62.5% of the clustered isolates and 36.6% of all isolates typed were grouped into six major shared types. A comparison of the spoligotypes with those in databases for Scandinavian countries showed that 33% of the isolates belonged to an ill-defined T family, followed by the EAI (22%), Haarlem (20%), LAM (11%), Central Asian (5%), X (5%), and Beijing (4%) families. Both the highest number of cases and the proportion of clustered cases were observed in patients ages 15 to 39 years. Nearly 10% of the isolates were resistant to one or more drugs (essentially limited to isoniazid monoresistance). However, none of the strains were multidrug resistant. Data on the geographic origins of the patients showed that more than two-thirds of the clustered patients with tuberculosis were foreign-born individuals or refugees. These results are explained on the basis of both the historical links within specific countries and recently imported cases of tuberculosis into Sweden.
采用两种基于聚合酶链反应的技术(间隔寡核苷酸分型和可变数目串联重复序列分析)相结合的方法,对瑞典患者中结核分枝杆菌分离株的基因多样性进行了测定。结果显示,23.6%的分离株聚类,近期传播率为14.1%。聚类分离株主要属于哈勒姆家族(23.2%),其次是北京家族(9.8%)、拉丁美洲和地中海家族(LAM;8%)以及东非-印度家族(EAI;6.2%)。将间隔寡核苷酸分型结果与国际间隔寡核苷酸分型数据库中的结果进行比较,发现62.5%的聚类分离株和36.6%的所有分型分离株被归为六大主要共享类型。将间隔寡核苷酸分型结果与斯堪的纳维亚国家数据库中的结果进行比较,发现33%的分离株属于定义不明确的T家族,其次是EAI家族(22%)、哈勒姆家族(20%)、LAM家族(11%)、中亚家族(5%)、X家族(5%)和北京家族(4%)。15至39岁的患者中病例数最多,聚类病例比例也最高。近10%的分离株对一种或多种药物耐药(主要限于异烟肼单耐药)。然而,没有菌株对多种药物耐药。患者地理来源的数据显示,超过三分之二的聚类结核病患者是外国出生的个体或难民。这些结果可根据特定国家内部的历史联系以及近期输入瑞典的结核病病例来解释。