Velayati Ali Akbar, Farnia Parissa, Mozafari Mohadese, Malekshahian Donya, Farahbod Amir Masoud, Seif Shima, Rahideh Snaz, Mirsaeidi Mehdi
From the Mycobacteriology Research Centre, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Division of Pulmonary and Critical Care, University of Illinois at Chicago, Chicago, IL.
Chest. 2015 Apr;147(4):1094-1102. doi: 10.1378/chest.14-0960.
The potential role of environmental Mycobacterium tuberculosis in the epidemiology of TB remains unknown. We investigated the transmission of M tuberculosis from humans to the environment and the possible transmission of M tuberculosis from the environment to humans.
A total of 1,500 samples were collected from three counties of the Tehran, Iran metropolitan area from February 2012 to January 2014. A total of 700 water samples (47%) and 800 soil samples (53%) were collected. Spoligotyping and the mycobacterial interspersed repetitive units-variable number of tandem repeats typing method were performed on DNA extracted from single colonies. Genotypes of M tuberculosis strains isolated from the environment were compared with the genotypes obtained from 55 patients with confirmed pulmonary TB diagnosed during the study period in the same three counties.
M tuberculosis was isolated from 11 of 800 soil samples (1%) and 71 of 700 water samples (10%). T family (56 of 82, 68%) followed by Delhi/CAS (11 of 82, 13.4%) were the most frequent M tuberculosis superfamilies in both water and soil samples. Overall, 27.7% of isolates in clusters were related. No related typing patterns were detected between soil, water, and clinical isolates. The most frequent superfamily of M tuberculosis in clinical isolates was Delhi/CAS (142, 30.3%) followed by NEW-1 (127, 27%). The bacilli in contaminated soil (36%) and damp water (8.4%) remained reculturable in some samples up to 9 months.
Although the dominant M tuberculosis superfamilies in soil and water did not correspond to the dominant M tuberculosis family in patients, the presence of circulating genotypes of M tuberculosis in soil and water highlight the risk of transmission.
环境中的结核分枝杆菌在结核病流行病学中的潜在作用尚不清楚。我们调查了结核分枝杆菌从人到环境的传播以及从环境到人的可能传播。
2012年2月至2014年1月,从伊朗德黑兰大都市区的三个县共采集了1500份样本。共采集了700份水样(47%)和800份土壤样本(53%)。对从单个菌落中提取的DNA进行了间隔寡核苷酸分型(Spoligotyping)和分枝杆菌插入重复单位-可变数目串联重复序列分型方法。将从环境中分离出的结核分枝杆菌菌株的基因型与在同一三个县研究期间确诊的55例肺结核患者获得的基因型进行比较。
在800份土壤样本中有11份(1%)和700份水样中有71份(10%)分离出结核分枝杆菌。在水样和土壤样本中,T家族(82份中的56份,68%)其次是德里/CAS家族(82份中的11份,13.4%)是最常见的结核分枝杆菌超家族。总体而言,聚类中的分离株有27.7%相关。在土壤、水和临床分离株之间未检测到相关的分型模式。临床分离株中最常见的结核分枝杆菌超家族是德里/CAS(142例,30.3%)其次是NEW-1(127例,27%)。在一些样本中,污染土壤中的杆菌(36%)和潮湿水中的杆菌(8.4%)在长达9个月的时间里仍可再培养。
虽然土壤和水中占主导地位的结核分枝杆菌超家族与患者中占主导地位的结核分枝杆菌家族不一致,但土壤和水中存在结核分枝杆菌的流行基因型突出了传播风险。