Multidisciplinary Research Laboratory, Clementino Fraga Filho University Hospital, Institute of Thoracic Diseases, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.
Int J Tuberc Lung Dis. 2012 Oct;16(10):1377-82. doi: 10.5588/ijtld.11.0709. Epub 2012 Aug 3.
We recently described the Mycobacterium tuberculosis RD(Rio) genotype, a clonally derived sublineage within the Latin American-Mediterranean (LAM) family. Genetic diversity of M. tuberculosis likely affects the clinical aspects of tuberculosis (TB). Prospective studies that address this issue are scarce and remain controversial.
To determine the association of differential clinical features of pulmonary TB with the RD(Rio) M. tuberculosis etiology.
Culture-proven pulmonary TB patients (n = 272) were clinically evaluated, including history, physical examination, chest X-ray and anti-human immunodeficiency virus serology. Isolates were classified as RD(Rio) or non-RD(Rio) M. tuberculosis by multiplex polymerase chain reaction and further spoligotyped. Clinical and M. tuberculosis genotype data were analyzed.
RD(Rio) M. tuberculosis caused disease in 26.5% (72/270) of all TB cases. The LAM genotype, of which RD(Rio) strains are members, was responsible for 46.0% of the TB cases. Demographic data, major signs and symptoms, radiographic presentation, microbiological features and clinical outcomes were not significantly different among patients with TB caused by RD(Rio) and non-RD(Rio) strains.
Disease caused by M. tuberculosis RD(Rio) strains was not clinically distinctive or more severe than disease caused by non-RD(Rio) strains in this series of TB patients. Larger prospective studies specifically designed to disclose differential clinical characteristics of TB caused by specific M. tuberculosis lineages are needed.
我们最近描述了结核分枝杆菌 RD(Rio) 基因型，这是拉丁美洲-地中海（LAM）家族中一个克隆衍生的亚谱系。结核分枝杆菌的遗传多样性可能会影响结核病（TB）的临床方面。解决这个问题的前瞻性研究很少，并且仍然存在争议。
确定结核分枝杆菌 RD(Rio) 病因与肺部结核的不同临床特征之间的关联。
对经培养证实的肺结核患者（n=272）进行临床评估，包括病史、体格检查、胸部 X 光和抗人类免疫缺陷病毒血清学检查。通过多重聚合酶链反应和进一步 spoligotyping 将分离株分类为 RD(Rio)或非 RD(Rio)结核分枝杆菌。分析临床和结核分枝杆菌基因型数据。
RD(Rio)结核分枝杆菌导致 270 例结核病患者中的 26.5%（72/270）患病。LAM 基因型，其 RD(Rio) 菌株是成员，占结核病患者的 46.0%。在由 RD(Rio)和非 RD(Rio)菌株引起的结核病患者中，人口统计学数据、主要体征和症状、放射学表现、微生物学特征和临床结果无显著差异。
在本系列结核病患者中，由结核分枝杆菌 RD(Rio) 菌株引起的疾病在临床上并不独特，也不比由非 RD(Rio) 菌株引起的疾病更严重。需要进行更大规模的前瞻性研究，专门揭示由特定结核分枝杆菌谱系引起的结核病的不同临床特征。
