Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Infect Genet Evol. 2012 Jan;12(1):28-37. doi: 10.1016/j.meegid.2011.10.001. Epub 2011 Oct 20.
Genotypes of Mycobacterium tuberculosis (MTB) are related to the geographic origin of the patients and population migration. The relationship between genotypes of MTB and clinical presentations has mainly focused on transmission of multi-drug resistant MTB strain in population. This study aimed to investigate the molecular epidemiology and dynamic change of MTB genotypes in Taiwan, and their association with clinical presentation among patients with pulmonary tuberculosis. A multi-center, two-year study which enrolled 516 patients with 516 MTB isolates was conducted, including: (1) 254 isolates from northern Taiwan; (2) 38 isolates from mid-western Taiwan; (3) 211 isolates from southern Taiwan; and (4) 13 isolates from the east coast of Taiwan. The isolates were genotyped with spoligotyping and standardized 12-loci-MIRU-VNTR method. The results showed Beijing/Beijing-like family was the major genotype of MTB in the northern (58%), eastern (53%), and southern (33%) regions. The second most widely spread lineage were the EAI-Manila (20% in the west and south) and Haarlem family (13-27% in the south, west, and east). According to the cluster analysis of 12-MIRU-VNTR genotypes, there were differences in distribution of MTB genotype between the northern and southern regions, and a temporal relationship between isolation year and 12-MIRU-VNTR genotype especially in loci 26 and 39 might exist. Furthermore, some patients with cavity lesions on chest films were associated with a cluster of Beijing family MTB strains, which can be defined by cluster analysis of 12-MIRU-VNTR genotype. However, the results of 12-loci-MIRU-VNTR genotyping in a longitudinal study should be interpreted with caution due to its short term instability. Further investigations of different molecular methodologies are necessary.
结核分枝杆菌（Mycobacterium tuberculosis，MTB）的基因型与患者的地理来源和人口迁移有关。MTB 基因型与临床表型的关系主要集中在人群中耐多药 MTB 菌株的传播上。本研究旨在调查台湾地区 MTB 基因型的分子流行病学和动态变化，及其与肺结核患者临床表型的关系。一项多中心、为期两年的研究共纳入 516 例肺结核患者的 516 株 MTB 分离株，包括：（1）北部台湾 254 株；（2）中西部台湾 38 株；（3）南部台湾 211 株；（4）台湾东海岸 13 株。采用 spoligotyping 和标准化 12 位基因 MIRU-VNTR 方法对分离株进行基因分型。结果显示，北京/北京样家族是北部（58%）、东部（53%）和南部（33%）地区 MTB 的主要基因型。第二广泛传播的谱系是 EAI-Manila（西部和南部占 20%）和 Haarlem 家族（南部、西部和东部占 13-27%）。根据 12-MIRU-VNTR 基因型聚类分析，北部和南部地区 MTB 基因型分布存在差异，分离年份与 12-MIRU-VNTR 基因型之间可能存在时间关系，特别是在 26 和 39 位。此外，一些胸片有空腔病变的患者与北京家族 MTB 菌株的聚类有关，可通过 12-MIRU-VNTR 基因型聚类分析来定义。然而，由于其短期不稳定，12 位基因 MIRU-VNTR 基因分型的纵向研究结果应谨慎解释。需要进一步研究不同的分子方法。
