Shemyakin I G, Stepanshina V N, Ivanov I Y, Lipin M Y, Anisimova V A, Onasenko A G, Korobova O V, Shinnick T M
State Research Center for Applied Microbiology, Obolensk, Russian Federation.
Int J Tuberc Lung Dis. 2004 Oct;8(10):1194-203.
Tuberculosis ward of a prison in Russia.
Molecular characterization of drug-resistant isolates.
Isolates were collected from all tuberculosis patients occurring in the prison over a 1-year period.
Of 130 patients studied, 17 patients produced pan-susceptible isolates and 113 produced isolates resistant to at least one drug, including 85 multidrug-resistant isolates. Mutations at katG315 occurred in 98% of isoniazid-resistant isolates. Mutations in rpoB were found in 89% of rifampicin-resistant isolates. Mutations in pncA occurred in 13% of the 75 isolates tested. By spoligotyping, members of the Beijing (55 isolates) and LAM (31 isolates) families were identified. By IS6110 genotyping, two groups (34 and 55 isolates) of related isolates were found, including three clusters (10, 12, and 16 isolates) with identical patterns. In a study of samples collected 3 months apart from 28 patients, four patients produced isolates containing a mixture of strains and five patients produced specimens containing distinctly different isolates. Isolates of nine patients acquired additional drug resistance.
Three families of strains accounted for much of the drug-resistant tuberculosis in this population. Multiple resistance, acquisition of resistance, and infection with two or more strains as well as reinfection were observed.
俄罗斯一所监狱的结核病病房。
对耐药菌株进行分子特征分析。
在1年时间内收集该监狱所有结核病患者的菌株。
在研究的130例患者中，17例患者产生全敏感菌株，113例患者产生至少对一种药物耐药的菌株，其中包括85例耐多药菌株。98%的耐异烟肼菌株发生katG315突变。89%的耐利福平菌株发现rpoB突变。在75株受试菌株中，13%发生pncA突变。通过间隔寡核苷酸分型，鉴定出北京家族（55株）和LAM家族（31株）的成员。通过IS6110基因分型，发现两组相关菌株（34株和55株），包括三个具有相同模式的簇（10株、12株和16株）。在一项对28例患者间隔3个月采集的样本的研究中，4例患者产生的菌株含有混合菌株，5例患者产生的标本含有明显不同的菌株。9例患者的菌株获得了额外的耐药性。
三个菌株家族占该人群耐药结核病的大部分。观察到多重耐药、耐药性获得、感染两种或更多菌株以及再感染情况。
