Glynn Judith R, Crampin Amelia C, Traore Hamidou, Chaguluka Steve, Mwafulirwa Donex T, Alghamdi Saad, Ngwira Bagrey M M, Yates Malcolm D, Drobniewski Francis D, Fine Paul E M
London School of Hygiene and Tropical Medicine, London, UK.
Emerg Infect Dis. 2008 Jul;14(7):1060-6. doi: 10.3201/eid1407.060468.
Tuberculosis patients with identical strains of Mycobacterium tuberculosis are described as clustered. Cluster size may depend on patient or strain characteristics. In a 7-year population-based study of tuberculosis in Karonga District, Malawi, clusters were defined by using IS6110 restriction fragment length polymorphism, excluding patterns with <5 bands. Spoligotyping was used to compare strains with an international database. Among 682 clustered patients, cluster size ranged from 2 to 37. Male patients, young adults, and town residents were over-represented in large clusters. Cluster size was not associated with HIV status or death from tuberculosis. Spoligotypes from 9 (90%) of 10 large cluster strains were identical or very similar (1 spacer different) to common spoligotypes found elsewhere, compared with 37 (66%) of 56 of those from nonclustered patients (p = 0.3). Large clusters were associated with factors likely to be related to social mixing, but spoligotypes of common strains in this setting were also common types elsewhere, consistent with strain differences in transmissibility.
具有相同结核分枝杆菌菌株的肺结核患者被描述为聚集性病例。聚集规模可能取决于患者或菌株特征。在一项针对马拉维卡龙加区结核病进行的为期7年的基于人群的研究中，通过使用IS6110限制性片段长度多态性来定义聚集性病例，排除条带数少于5条的模式。运用间隔寡核苷酸分型技术（Spoligotyping）将菌株与国际数据库进行比较。在682例聚集性病例患者中，聚集规模从2例到37例不等。男性患者、年轻人和城镇居民在大型聚集中所占比例过高。聚集规模与HIV感染状况或结核病死亡无关。10个大型聚集菌株中有9个（90%）的间隔寡核苷酸分型与在其他地方发现的常见间隔寡核苷酸分型相同或非常相似（相差1个间隔区），相比之下，56例非聚集性病例患者中有37个（66%）是这样（p = 0.3）。大型聚集与可能与社会交往相关的因素有关，但在这种情况下常见菌株的间隔寡核苷酸分型在其他地方也是常见类型，这与菌株传播性的差异一致。
