National Tuberculosis Reference Laboratory, Laboratory for Infectious Diseases and Perinatal Screening (LIS), Centre for Infectious Disease Control (CIB), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
Euro Surveill. 2014 Mar 20;19(11):20742. doi: 10.2807/1560-7917.es2014.19.11.20742.
The European Centre for Disease Prevention and Control (ECDC) initiated a project on the molecular surveillance of multi- and extensively drug-resistant tuberculosis (MDR-/XDR-TB) transmission in the European Union (EU) in the period from 2009 to 2011. In total, 2,092 variable number of tandem repeat (VNTR) patterns of MDR-/XDR-TB Mycobacterium tuberculosis isolates were collected, originating from 24 different countries in the period 2003 to 2011. Of the collected VNTR patterns, 45% (n=941) could be assigned to one of the 79 European multiple-country molecular fingerprint clusters and 50% of those (n=470) belonged to one extremely large cluster caused by Beijing strains of one genotype. We conclude that international transmission of MDR-/XDR-TB plays an important role in the EU, especially in the eastern part, and is significantly related to the spread of one strain or clone of the Beijing genotype. Implementation of international cluster investigation in EU countries should reveal underlying factors of transmission, and show how TB control can be improved regarding case finding, contact tracing, infection control and treatment in order to prevent further spread of MDR-/XDR-TB in the EU.
欧洲疾病预防控制中心（ECDC）于 2009 年至 2011 年期间在欧盟启动了一项关于耐多药/广泛耐药结核病（MDR-/XDR-TB）传播的分子监测项目。共收集了来自 24 个不同国家的 2092 株 MDR-/XDR-TB 分枝杆菌分离株的可变数目串联重复（VNTR）模式，收集时间为 2003 年至 2011 年。在所收集的 VNTR 模式中，45%（n=941）可归属于 79 个欧洲多国分子指纹簇之一，其中 50%（n=470）属于由一个基因型的北京株引起的一个特大簇。我们的结论是，MDR-/XDR-TB 的国际传播在欧盟，特别是在东部地区，发挥了重要作用，与一种菌株或北京基因型的克隆的传播有很大关系。在欧盟国家实施国际集群调查应揭示传播的潜在因素，并展示如何通过发现病例、追踪接触者、感染控制和治疗来改善结核病控制，以防止 MDR-/XDR-TB 在欧盟进一步传播。
