Millet Julie, Streit Elisabeth, Berchel Mylène, Bomer Anne-Gaël, Schuster Franziska, Paasch Delaina, Vanhomwegen Jessica, Cadelis Gilbert, Rastogi Nalin
WHO Supranational TB Reference Laboratory, Unité de la Tuberculose et des Mycobactéries, Institut Pasteur de Guadeloupe, 97183 Abymes, Guadeloupe, France.
Service de Pneumologie, CHU de Pointe-à-Pitre, 97110 Pointe-à-Pitre, Guadeloupe, France ; Centre de Lutte Antituberculeux de la Guadeloupe, CHU de Pointe-à-Pitre, 97110 Pointe-à-Pitre, Guadeloupe, France.
Biomed Res Int. 2014;2014:689852. doi: 10.1155/2014/689852. Epub 2014 Mar 13.
THE population of the French Departments of the Americas (FDA) is highly influenced by the intense migratory flows with mainland france and surrounding countries of the Caribbean and Latin America, some of which have high incidence rates of tuberculosis (Haiti: 230/100,000; Guyana: 111/100,000; and Suriname: 145/100,000) and drug resistance. Since the development of drug resistance to conventional antituberculous drugs has a major impact on the treatment success of tuberculosis, we therefore decided to review carefully Mycobacterium tuberculosis drug resistance and associated genotypic lineages in the FDA over a seventeen-year period (January 1995-December 2011). A total of 1239 cases were studied, including 153 drug-resistant and 26 multidrug-resistant- (MDR-) TB cases, representing 12.3% and 2.1% of the TB cases in our study setting. A significantly higher proportion of M. tuberculosis isolates among relapse cases showed drug resistance to isoniazid (22.5%, P = 0.002), rifampicin (20.0%, P < 0.001), or both (MDR-TB, 17.5%; P < 0.001). Determination of spoligotyping based phylogenetic clades showed that among the five major lineages observed--T family (30.1%); Latin-American and Mediterranean (LAM, 23.7%); Haarlem (H, 22.2%); East-African Indian (EAI, 7.2%); and X family (6.5%)--two lineages, X and LAM, were overrepresented in drug-resistant and MDR-TB cases, respectively. Finally, 19 predominant spoligotypes were identified for the 1239 isolates of M. tuberculosis in our study among which 4 were significantly associated with drug resistance corresponding to SIT20/LAM1, SIT64/LAM6, SIT45/H1, and SIT46/undefined lineage.
法属美洲诸省（FDA）的人口受到与法国本土以及加勒比和拉丁美洲周边国家之间频繁移民潮的极大影响，其中一些国家结核病发病率很高（海地：230/10万；圭亚那：111/10万；苏里南：145/10万）且存在耐药情况。由于对传统抗结核药物产生耐药性对结核病治疗的成功有着重大影响，因此我们决定仔细回顾17年间（1995年1月至2011年12月）法属美洲诸省结核分枝杆菌的耐药情况及相关基因型谱系。共研究了1239例病例，其中包括153例耐药病例和26例耐多药（MDR）结核病病例，分别占我们研究病例中结核病病例的12.3%和2.1%。复发病例中结核分枝杆菌分离株对异烟肼耐药（22.5%，P = 0.002）、利福平耐药（20.0%，P < 0.001）或两者均耐药（MDR - TB，17.5%；P < 0.001）的比例显著更高。基于间隔寡核苷酸分型（spoligotyping）确定的系统发育分支显示，在所观察到的五个主要谱系中——T家族（30.1%）；拉丁美洲和地中海型（LAM，23.7%）；哈勒姆型（H，22.2%）；东非印度型（EAI，7.2%）；以及X家族（6.5%）——X和LAM这两个谱系分别在耐药和MDR - TB病例中占比过高。最后，在我们的研究中，对1239株结核分枝杆菌分离株鉴定出了19种主要的间隔寡核苷酸分型，其中4种与耐药性显著相关，分别对应SIT20/LAM1、SIT64/LAM6、SIT45/H1和SIT46/未定义谱系。
