伊朗和阿富汗耐多药结核病患者中哈勒姆I型和北京型结核分枝杆菌菌株的流行情况。

Prevalence of Haarlem I and Beijing types of Mycobacterium tuberculosis strains in Iranian and Afghan MDR-TB patients.

作者信息

Farnia Parissa, Masjedi Mohamad Reza, Mirsaeidi Mehdi, Mohammadi Foroozan, Vincent Veronique, Bahadori Moslem, Velayati Ali Akbar

机构信息

National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shaheed Bahonar Avenue, Darabad, P.O. Box 19575/154, Tehran 19556, Iran.

出版信息

J Infect. 2006 Nov;53(5):331-6. doi: 10.1016/j.jinf.2005.12.020. Epub 2006 Feb 14.

DOI:10.1016/j.jinf.2005.12.020

PMID:16476483

Abstract

OBJECTIVES

This survey identified the spoligopatterns of Mycobacterium tuberculosis strains with an international designation responsible for transmission and prevalence of Multi-Drug Resistance Tuberculosis (MDR-TB) among native and immigrant population of Tehran (2000-2005).

METHODS

The spacer oligonucleotides typing was performed on 263 M. tuberculosis strains isolated from verified cases of MDR-TB. Clinical and demographical data of patients were collected using traditional methods.

RESULTS

Classical epidemiological investigation revealed that out of 263 MDR-TB cases, 175, 66.5% were isolated from Afghan immigrants. In both communities, majority of MDR-TB cases had either previous history of TB (107, 40.6%) or had a close contact (84, 31.9%). By spoligotyping, 27 distinct patterns were observed, 253 clinical isolates were grouped in 17 clusters (62.9%) and 10 isolates displayed an orphan pattern (37%). Based on an international spoligotype database, Haarlem I (85, 33.5%), Beijing (52, 20.5%), Central Asia (32, 12.1%), and EAI (21, 8.3%) were the major identified super families. Although, 76.9% of the Beijing genotypes and 100% of ST(253) strains (that was prevalent through former Soviet Union) were isolated from Afghan patients only. The linkage patterns between 30 Iranian and Afghan patients were observed.

CONCLUSION

The study highlighted the epidemic potential of Haarlem I and Beijing genotypes among MDR-TB cases in Tehran territory.

摘要

目的

本调查确定了具有国际命名的结核分枝杆菌菌株的间隔寡核苷酸分型模式，这些菌株导致了德黑兰本地人和移民人群中耐多药结核病（MDR-TB）的传播和流行（2000 - 2005年）。

方法

对从确诊的耐多药结核病病例中分离出的263株结核分枝杆菌菌株进行间隔寡核苷酸分型。使用传统方法收集患者的临床和人口统计学数据。

结果

经典的流行病学调查显示，在263例耐多药结核病病例中，175例（66.5%）分离自阿富汗移民。在两个群体中，大多数耐多药结核病病例既往有结核病病史（107例，40.6%）或有密切接触史（84例，31.9%）。通过间隔寡核苷酸分型，观察到27种不同的模式，253株临床分离株被分为17个簇（62.9%），10株分离株呈现孤儿模式（37%）。基于国际间隔寡核苷酸分型数据库，哈勒姆I型（85株，33.5%）、北京型（52株，20.5%）、中亚型（32株，12.1%）和东亚型（21株，8.3%）是主要鉴定出的超级家族。尽管如此，76.9%的北京基因型和100%的ST(253)菌株（在前苏联流行）仅从阿富汗患者中分离得到。观察到30例伊朗和阿富汗患者之间的连锁模式。