de Jong B C, Hill P C, Aiken A, Jeffries D J, Onipede A, Small P M, Adegbola R A, Corrah T P
Bacterial Diseases Programme, Medical Research Council Laboratories, Banjul, The Gambia.
Int J Tuberc Lung Dis. 2007 Apr;11(4):450-6.
A tuberculosis (TB) case contact study in the Gambia.
To test whether Mycobacterium africanum, which has lost around 68 kb compared with M. tuberculosis sensu stricto, causes less severe TB disease.
We genotyped mycobacterial isolates and compared clinical and radiological characteristics as well as outcome data of M. africanum-infected TB patients with those infected with M. tuberculosis.
Of 317 index cases, 301 had a mycobacterial isolate available, 290 of which had an interpretable spoligotype pattern. Of these, 110 isolates (38%) were M. africanum and 180 (62%) were M. tuberculosis. M. africanum cases had lower body mass indices (17 vs. 17.45 for M. tuberculosis-infected patients, P = 0.029) and their radiographic disease was more extensive (96% vs. 89% had at least moderately severe radiographic changes, P = 0.031). Outcome on treatment was similar (2.8% of human immunodeficiency virus [HIV] negative M. africanum patients died on treatment vs. 3.0% of M. tuberculosis patients, P = 0.95).
M. africanum causes sputum smear-positive tuberculosis disease that is at least as severe as that caused by M. tuberculosis sensu stricto. Further clinical comparisons may be helpful in smear-negative patients and HIV-TB co-infected patients, and to identify whether there is any difference in time to develop disease.
在冈比亚进行的一项结核病病例接触者研究。
检验与结核分枝杆菌狭义种相比已缺失约68 kb的非洲分枝杆菌是否会导致病情较轻的结核病。
我们对分枝杆菌分离株进行基因分型，并比较非洲分枝杆菌感染的结核病患者与结核分枝杆菌感染患者的临床、放射学特征及转归数据。
在317例索引病例中，301例有可用的分枝杆菌分离株，其中290例具有可解读的间隔寡核苷酸分型模式。其中，110株分离株（38%）为非洲分枝杆菌，180株（62%）为结核分枝杆菌。非洲分枝杆菌感染病例的体重指数较低（结核分枝杆菌感染患者为17，非洲分枝杆菌感染患者为17.45，P = 0.029），其放射学疾病范围更广（96% vs. 89%至少有中度严重的放射学改变，P = 0.031）。治疗转归相似（人类免疫缺陷病毒[HIV]阴性的非洲分枝杆菌感染患者中有2.8%在治疗期间死亡，结核分枝杆菌感染患者为3.0%，P = 0.95）。
非洲分枝杆菌引起的痰涂片阳性结核病至少与结核分枝杆菌狭义种引起的结核病一样严重。进一步的临床比较可能有助于痰涂片阴性患者和HIV-TB合并感染患者，并确定发病时间是否存在差异。
