Huber Fé Dagmar, Sánchez Alexandra, Gomes Harrison Magdinier, Vasconcellos Sidra, Massari Véronique, Barreto Angela, Cesconi Vanderci, de Almeida Machado Silvia Maria, Gomgnimbou Michel K, Sola Christophe, Larouzé Bernard, Suffys Philip Noel, Saad Maria Helena Féres
Laboratory of Cellular Microbiology, Oswaldo Cruz Institute (IOC), Fiocruz, Rio de Janeiro, Brazil.
Tuberculosis Control Program and Coordination Management in Prison Health, State Department of Corrections, Rio de Janeiro, Brazil.
Infect Genet Evol. 2014 Aug;26:194-202. doi: 10.1016/j.meegid.2014.05.031. Epub 2014 Jun 5.
Tuberculosis (TB) is still a serious public health problem, continuing to be an important threat for confined populations. We used spoligotyping to estimate the genotypic clades of Mycobacterium tuberculosis isolates from inmates in two blocks in a southeastern Brazilian prison unit, with TB incidence rate of 8185/100.000. The Latin American Mediterranean (LAM) clade is well represented in the country, and the LAM specific molecular markers, RD(Rio) large sequence polymorphism and the SNP on the Rv3062 [ligB(1212)], were used to characterize spoligotype signatures from prison isolates. Typing of RD(Rio) and ligB increase LAM clade from 66.7% (n=72/108) to 69.4% (n=75). The LAM2 SIT17 (n=23) and SIT179 (n=12) signatures comprised one third of all isolates, followed by Haarlem (11.5%, n=12), T (8.7%, n=9) and X (5.7%, n=6) clades. Strains with unknown signatures represented 5.5% (n=6), and four (3.7%) did not match any lineage. We observed RD(Rio) among 64 (59.2%) isolates, and 54 (50%) were of the LAM clade. In particular, the LAM2/RD(Rio) sub-lineage was significantly associated with clustering (p=0.02) and its frequency was higher (32%) when compared to that of the previous general TB cases in RJ (4.29%). Overall cluster frequency defined by spoligotyping/IS6110-RFLP was 62%. The two evolutionary markers helped to evaluate some LAM signature misconceptions and demonstrate that LAM2/RD(Rio) was found with high frequency, hitherto being unnoticed. All these data, allied to high clustering, imply that public health measures to minimize the escalation of TB in prison is essential, and both spoligotyping as well as RD(Rio) would be useful tools to monitor the effects of the measures with respect to M. tuberculosis lineage variation.
结核病（TB）仍然是一个严重的公共卫生问题，持续对封闭人群构成重大威胁。我们使用间隔寡核苷酸分型法（spoligotyping）来估计巴西东南部一个监狱单位两个监区的结核分枝杆菌分离株的基因型分支，该监狱的结核病发病率为8185/100000。拉丁美洲地中海（LAM）分支在该国占比很高，并且利用LAM特异性分子标记，即RD（里约）大片段序列多态性以及Rv3062[ligB(1212)]上的单核苷酸多态性（SNP），来鉴定监狱分离株的间隔寡核苷酸分型特征。对RD（里约）和ligB进行分型后，LAM分支的占比从66.7%（n=72/108）增加到69.4%（n=75）。LAM2 SIT17（n=23）和SIT179（n=12）特征的分离株占所有分离株的三分之一，其次是哈勒姆分支（11.5%，n=12）、T分支（8.7%，n=9）和X分支（5.7%，n=6）。特征未知的菌株占5.5%（n=6），有4株（3.7%）与任何谱系均不匹配。我们在64株（59.2%）分离株中检测到RD（里约），其中54株（50%）属于LAM分支。特别是，LAM2/RD（里约）亚谱系与聚集性显著相关（p=0.02），并且与里约热内卢之前的一般结核病病例相比，其频率更高（32%），而之前里约热内卢一般结核病病例的该频率为4.29%。通过间隔寡核苷酸分型法/IS6110限制性片段长度多态性（RFLP）确定的总体聚集频率为62%。这两个进化标记有助于评估一些关于LAM特征的误解，并证明LAM2/RD（里约）的发现频率很高，而此前一直未被注意到。所有这些数据，再加上高聚集性，意味着采取公共卫生措施以尽量减少监狱中结核病的传播至关重要，并且间隔寡核苷酸分型法以及RD（里约）将是监测这些措施对结核分枝杆菌谱系变异影响的有用工具。
