Mokrousov Igor, Otten Tatiana, Zozio Thierry, Turkin Eugeni, Nazemtseva Vera, Sheremet Aleksandra, Vishnevsky Boris, Narvskaya Olga, Rastogi Nalin
Laboratory of Molecular Microbiology, St Petersburg Pasteur Institute, St Petersburg, Russia.
FEMS Immunol Med Microbiol. 2009 Jan;55(1):13-22. doi: 10.1111/j.1574-695X.2008.00470.x. Epub 2008 Sep 17.
The Kaliningrad region is the westernmost part of the Russian Federation; it includes an enclave on the Baltic Sea inside the European Union separated from mainland Russia by Lithuania and Poland. The incidence of tuberculosis in Kaliningrad has shown a steady and dramatic increase from 83/100,000 in 2000 to 134/100,000 in 2006; the rate of multidrug-resistant tuberculosis (MDR-tuberculosis) in the Kaliningrad region was reported to be 30.5% among newly diagnosed tuberculosis patients. This study presents a first molecular snapshot of the population diversity of Mycobacterium tuberculosis in this region. A total of 90 drug-resistant and susceptible M. tuberculosis strains from Kaliningrad were subjected to spoligotyping, 12-locus MIRU typing and mutation analysis of the drug resistance genes rpoB and katG. A comparison with international databases showed that the M. tuberculosis population in this region shares a joint pool of strains with the European part of Russia, and also exhibits a certain affinity with those of its northern European neighbours, such as Poland and Germany. Comparison of the genotyping and drug resistance data emphasized that the high prevalence of the MDR Beijing genotype strains is a major cause of the adverse epidemiological situation of MDR-tuberculosis in the Kaliningrad region.
加里宁格勒地区是俄罗斯联邦最西部的地区；它包括欧盟内波罗的海沿岸的一块飞地，被立陶宛和波兰与俄罗斯大陆隔开。加里宁格勒的结核病发病率呈稳步且显著上升趋势，从2000年的83/10万增至2006年的134/10万；据报道，加里宁格勒地区新诊断的结核病患者中耐多药结核病（MDR - 结核病）的比例为30.5%。本研究首次呈现了该地区结核分枝杆菌种群多样性的分子概况。对来自加里宁格勒的90株耐药和敏感结核分枝杆菌菌株进行了间隔寡核苷酸分型（spoligotyping）、12位点多位点可变数目串联重复序列分型（MIRU分型）以及耐药基因rpoB和katG的突变分析。与国际数据库的比较表明，该地区的结核分枝杆菌种群与俄罗斯欧洲部分共享一个菌株库，并且与北欧邻国如波兰和德国的菌株也表现出一定的亲缘关系。基因分型和耐药数据的比较强调，MDR北京基因型菌株的高流行率是加里宁格勒地区MDR - 结核病不良流行状况的主要原因。
