Ano Hiromi, Matsumoto Tomoshige, Yoshida Hiroko, Nagai Muneyuki, Tamura Yoshitaka, Nishimori Kei, Kawahara Kunimitsu, Takashima Tetsuya, Tsuyuguchi Izuo
Correspondence to: Hiromi Ano, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, 3-7-1, Habikino, Habikino-shi, Osaka 583-8588 Japan.
Kekkaku. 2006 Apr;81(4):321-8.
To analyze the situation of tuberculosis infection by DNA fingerprinting in the middle and eastern part of Osaka, Japan.
We performed IS6110 restriction fragment length polymorphism (RFLP) on 1200 isolates from tuberculosis patients who visited our hospital from January 2001 to December 2003. A cluster was defined as a series of isolates with more than 90% similarity by IS6110 RFLP and those with the same drug-susceptibility pattern. The isolates with fewer than six copies of IS6110 were considered to be clustered if the IS6110 RFLP patterns and the variable numbers of tandem repeats with 16 regions of ETR and MIRU "allele profile" were identical.
The number of samples in incremental study periods was 422 in 2001, 817 between 2001 and 2002 and 1200 between 2001 and 2003. The percentage of clustered cases was 27.8% in 2001, 19.1% in 2002 and 19.5% in 2003. The cumulative percentage of clustered cases was 27.8% in the first year, 29.7% over two years and 32.6% over three years. The percentage of clustered cases of isolates with a drug resistance was significantly lower (25.0%) than that of drug susceptible isolates (33.7%). Next, we investigated the clustered cases by gender and age. The percentage of clustered cases with isolates from young males and females (0-19 years old) was 23.8%. In contrast, the percentage of clustered cases with isolates from 20-59 year-old females gradually decreased from 14.7% to 4.4%. Conversely, the percentage of clustered cases from young and middle aged male (20-59 years old) was higher (20.2%-32.4%) than that of females.
The sharp increase in the cumulative cluster formation rate was curbed by the decline in the tuberculosis incidence rate in Osaka, Japan, after the first year of examination. We thought that this phenomenon suggests the success of the anti-tuberculosis measure in Japan.
通过DNA指纹图谱分析日本大阪中东部地区的结核感染情况。
我们对2001年1月至2003年12月期间来我院就诊的肺结核患者的1200株分离菌株进行了IS6110限制性片段长度多态性（RFLP）分析。聚类被定义为通过IS6110 RFLP分析相似度超过90%且药敏模式相同的一系列分离菌株。如果IS6110 RFLP模式以及16个ETR和MIRU区域的可变串联重复序列的“等位基因谱”相同，则将IS6110拷贝数少于6个的分离菌株视为聚类。
在逐年递增的研究期间，2001年的样本数量为422例，2001年至2002年为817例，2001年至2003年为1200例。2001年聚类病例的百分比为27.8%，2002年为19.1%，2003年为19.5%。聚类病例的累积百分比在第一年为27.8%，两年为29.7%，三年为32.6%。耐药分离菌株的聚类病例百分比（25.0%）显著低于药敏分离菌株（33.7%）。接下来，我们按性别和年龄对聚类病例进行了调查。0至19岁年轻男性和女性分离菌株的聚类病例百分比为23.8%。相比之下，20至59岁女性分离菌株的聚类病例百分比从14.7%逐渐降至4.4%。相反，20至59岁年轻和中年男性分离菌株的聚类病例百分比（20.2% - 32.4%）高于女性。
在日本大阪，检查第一年之后，结核病发病率的下降抑制了累积聚类形成率的急剧上升。我们认为这种现象表明日本的抗结核措施取得了成功。
