Ritacco Viviana, López Beatriz, Cafrune Patricia I, Ferrazoli Lucilaine, Suffys Philip N, Candia Norma, Vásquez Lucy, Realpe Teresa, Fernández Jorge, Lima Karla V, Zurita Jeannete, Robledo Jaime, Rossetti Maria L, Kritski Afranio L, Telles Maria A, Palomino Juan C, Heersma Herre, van Soolingen Dick, Kremer Kristin, Barrera Lucía
Instituto Nacional de Enfermedades Infecciosas ANLIS Carlos Malbrá, Buenos Aires, Argentina.
Mem Inst Oswaldo Cruz. 2008 Aug;103(5):489-92. doi: 10.1590/s0074-02762008000500014.
The frequency of the Beijing genotype of Mycobacterium tuberculosis as a cause of tuberculosis (TB) in South America was determined by analyzing genotypes of strains isolated from patients that had been diagnosed with the disease between 1997 and 2003 in seven countries of the subcontinent. In total, 19 of the 1,202 (1.6%) TB cases carried Beijing isolates, including 11 of the 185 patients from Peru (5.9%), five of the 512 patients from Argentina (1.0%), two of the 252 Brazilian cases (0.8%), one of the 166 patients from Paraguay (0.6%) and none of the samples obtained from Chile (35), Colombia (36) and Ecuador (16). Except for two patients that were East Asian immigrants, all cases with Beijing strains were native South Americans. No association was found between carrying a strain with the Beijing genotype and having drug or multi-drug resistant disease. Our data show that presently transmission of M. tuberculosis strains of the Beijing genotype is not frequent in Latin America. In addition, the lack of association of drug resistant TB and infection with M. tuberculosis of the Beijing genotype observed presently demands efforts to define better the contribution of the virulence and lack of response to treatment to the growing spread of Beijing strains observed in other parts of the world.
通过分析1997年至2003年间在该次大陆七个国家被诊断患有结核病的患者所分离菌株的基因型，确定了北京基因型结核分枝杆菌作为南美洲结核病病因的频率。在总共1202例结核病病例中，有19例（1.6%）携带北京基因型菌株，其中包括来自秘鲁的185例患者中的11例（5.9%）、来自阿根廷的512例患者中的5例（1.0%）、252例巴西病例中的2例（0.8%）、来自巴拉圭的166例患者中的1例（0.6%），而从智利（35份样本）、哥伦比亚（36份样本）和厄瓜多尔（16份样本）获得的样本中均未发现。除了两名东亚移民患者外，所有携带北京基因型菌株的病例均为南美本地人。未发现携带北京基因型菌株与患有耐药或耐多药疾病之间存在关联。我们的数据表明，目前北京基因型结核分枝杆菌菌株在拉丁美洲的传播并不频繁。此外，目前观察到的耐药结核病与北京基因型结核分枝杆菌感染缺乏关联，这需要努力更好地确定毒力以及对治疗无反应在世界其他地区观察到的北京基因型菌株传播增加中所起的作用。
