National Institute of Health, Ministry of Health, Maputo, Mozambique.
PLoS One. 2013 Aug 7;8(8):e71999. doi: 10.1371/journal.pone.0071999. Print 2013.
The Beijing genotype is a lineage of Mycobacterium tuberculosis that is distributed worldwide and responsible for large epidemics, associated with multidrug-resistance. However, its distribution in Africa is less understood due to the lack of data. Our aim was to investigate the prevalence and possible transmission of Beijing strains in Mozambique by a multivariate analysis of genotypic, geographic and demographic data. A total of 543 M. tuberculosis isolates from Mozambique were spoligotyped. Of these, 33 were of the Beijing lineage. The genetic relationship between the Beijing isolates were studied by identification of genomic deletions within some Regions of Difference (RD), Restriction Fragment Length Polymorphism (RFLP) and Mycobacterial Interspersed Repetivie Unit - variable number tandem repeat (MIRU-VNTR). Beijing strains from South Africa, representing different sublineages were included as reference strains. The association between Beijing genotype, Human Immunodeficiency Virus (HIV) serology and baseline demographic data was investigated. HIV positive serostatus was significantly (p=0.023) more common in patients with Beijing strains than in patients with non-Beijing strains in a multivariable analysis adjusted for age, sex and province (14 (10.9%) of the 129 HIV positive patients had Beijing strains while 6/141 (4.3%) of HIV negative patients had Beijing strains). The majority of Beijing strains were found in the Southern region of Mozambique, particularly in Maputo City (17%). Only one Beijing strain was drug resistant (multi-drug resistant). By combined use of RD and spoligotyping, three genetic sublineages could be tentatively identified where a distinct group of four isolates had deletion of RD150, a signature of the "sublineage 7" recently emerging in South Africa. The same group was very similar to South African "sublineage 7" by RFLP and MIRU-VNTR, suggesting that this sublineage could have been recently introduced in Mozambique from South Africa, in association with HIV infection.
北京基因型是一种结核分枝杆菌株，分布于全球，与耐多药结核病的大流行有关。然而，由于数据缺乏，其在非洲的分布情况了解较少。我们的目的是通过对基因、地理和人口数据的多元分析，研究北京菌株在莫桑比克的流行情况及其可能的传播途径。从莫桑比克共分离出 543 株结核分枝杆菌，其中 33 株为北京株。通过鉴定一些差异区域（RD）、限制性片段长度多态性（RFLP）和分枝杆菌插入重复可变数串联重复（MIRU-VNTR）内的基因组缺失，研究了北京分离株之间的遗传关系。还包括南非的北京株代表不同的亚系作为参考株。研究了北京基因型与人类免疫缺陷病毒（HIV）血清学和基线人口统计学数据之间的关系。在调整年龄、性别和省份的多变量分析中，HIV 阳性患者中北京株的比例显著（p=0.023）高于非北京株（129 例 HIV 阳性患者中有 14 例（10.9%）为北京株，而 141 例 HIV 阴性患者中有 6 例（4.3%）为北京株）。大多数北京株发现于莫桑比克南部地区，特别是马普托市（17%）。只有一株北京株耐药（耐多药）。通过 RD 和 spoligotyping 的联合使用，可以初步确定三个遗传亚系，其中一组四个分离株的 RD150 缺失，这是南非最近出现的“亚系 7”的特征。该组与南非的“亚系 7”非常相似，通过 RFLP 和 MIRU-VNTR，表明该亚系可能是最近从南非引入莫桑比克的，与 HIV 感染有关。
