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结核病基因分型——美国,2004-2010 年。

Tuberculosis genotyping--United States, 2004-2010.

出版信息

MMWR Morb Mortal Wkly Rep. 2012 Sep 14;61(36):723-5.

Abstract

Tuberculosis (TB) genotyping is a laboratory-based genetic analysis of the bacteria that cause TB disease (i.e., any of the organisms in the Mycobacterium tuberculosis complex). When combined with epidemiologic data, TB genotyping has sufficient discriminatory power to help find TB cases likely to be in the same chain of transmission or determine that cases are not related. Since 2004, >70,000 M. tuberculosis isolates have been genotyped through partnerships between CDC, national genotyping laboratories, and state and local public health departments, with a goal to genotype at least one M. tuberculosis isolate for each case of culture-positive TB in the United States. National genotype surveillance coverage, or the proportion of culture-positive TB cases with a genotyped isolate, increased from 51.2% in 2004 to 88.2% in 2010. The TB Genotyping Information Management System (TB GIMS), accessible to public health departments through a secure, online web portal, was launched in 2010. TB GIMS enables systematic collection of genotyping results, which have been available since 2004, and integrates those results with epidemiologic, geographic, demographic, and clinical data collected by the National TB Surveillance System (NTSS) since 1993. Genotyping timeliness, represented by the median time from specimen collection until linked genotyping results and surveillance data are available to TB GIMS users, improved from 22 weeks in July 2010 to 11 weeks in December 2010. These improvements in genotype surveillance coverage and timeliness will improve outbreak detection efforts and enable more in-depth studies of TB epidemiology, leading to better use of limited public health resources.

摘要

结核病(TB)基因分型是对引起结核病(即结核分枝杆菌复合群中的任何一种生物体)的细菌进行的基于实验室的遗传分析。当与流行病学数据相结合时,结核病基因分型具有足够的区分能力,可帮助发现可能处于同一传播链中的结核病病例,或确定病例之间不存在关联。自 2004 年以来,通过美国疾病预防控制中心、国家基因分型实验室以及州和地方公共卫生部门之间的合作,对超过 70,000 株结核分枝杆菌分离株进行了基因分型,其目标是对美国每一例培养阳性的结核病病例至少进行一次结核分枝杆菌分离株的基因分型。全国基因型监测覆盖率,即培养阳性的结核病病例中具有基因分型分离株的比例,从 2004 年的 51.2%增加到 2010 年的 88.2%。TB 基因分型信息管理系统(TB GIMS)于 2010 年推出,公共卫生部门可通过安全的在线网络门户访问该系统。TB GIMS 能够系统地收集自 2004 年以来的基因分型结果,并将这些结果与自 1993 年以来国家结核病监测系统(NTSS)收集的流行病学、地理、人口和临床数据进行整合。基因分型的及时性(以从标本采集到将相关的基因分型结果和监测数据提供给 TB GIMS 用户的中位数时间来表示)得到了改善,从 2010 年 7 月的 22 周缩短至 2010 年 12 月的 11 周。基因型监测覆盖率和及时性的这些改进将改善暴发检测工作,并使我们能够对结核病流行病学进行更深入的研究,从而更好地利用有限的公共卫生资源。

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