2000 - 2008年台湾南部高雄市结核病的分子流行病学
Molecular epidemiology of tuberculosis in Kaohsiung City located at southern Taiwan, 2000-2008.
作者信息
Chen Yih-Yuan, Chang Jia-Ru, Kuo Shu-Chen, Tseng Fan-Chen, Huang Wei-Chen, Huang Tsi-Shu, Chen Yao-Shen, Chiueh Tzong-Shi, Sun Jun-Ren, Su Ih-Jen, Dou Horng-Yunn
机构信息
National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan; Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiaya City, Taiwan.
National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Miaoli, Taiwan.
出版信息
PLoS One. 2015 Jan 28;10(1):e0117061. doi: 10.1371/journal.pone.0117061. eCollection 2015.
BACKGROUND
We present the first comprehensive analysis of Mycobacterium tuberculosis (MTB) isolates circulating in southern Taiwan. In this 9-year population-based study, the TB situation in the Kaohsiung region was characterized by genotypic analysis of 421 MTB isolates.
METHODS
All 421 isolates of MTB were analyzed by spoligotyping and MIRU-VNTR typing. Drug-resistance patterns were also analyzed.
RESULTS
The percentage of EAI (East African-Indian) strains increased across sampling years (2000-2008) in southern Taiwan, whereas the proportion of Beijing lineages remained unchanged. Clustering was more frequent with EAI genotype infections (odds ratio = 3.6, p<0.0001) when compared to Beijing genotypes. Notably, MTB resistance to streptomycin (STR) had significantly increased over time, but resistance to other antibiotics, including multidrug resistance, had not. Three major genes (gidB, rpsL and rrs) implicated in STR resistance were sequenced and specific mutations identified.
CONCLUSIONS
This study revealed that EAI strains were highly transmissible and that STR resistance has increased between 2000 and 2008 in Kaohsiung, Taiwan.
背景
我们首次对台湾南部地区流行的结核分枝杆菌（MTB）分离株进行了全面分析。在这项为期9年的基于人群的研究中，通过对421株MTB分离株进行基因分型分析，描述了高雄地区的结核病疫情状况。
方法
对所有421株MTB分离株进行了间隔寡核苷酸分型（spoligotyping）和多位点可变数目串联重复序列分析（MIRU-VNTR）分型。同时也分析了耐药模式。
结果
在台湾南部，东非-印度型（EAI）菌株的比例在各采样年份（2000 - 2008年）有所增加，而北京家族株的比例保持不变。与北京基因型感染相比，EAI基因型感染的聚类现象更为常见（优势比 = 3.6，p<0.0001）。值得注意的是，MTB对链霉素（STR）的耐药性随时间显著增加，但对其他抗生素的耐药性，包括多重耐药性，并未增加。对涉及STR耐药性的三个主要基因（gidB、rpsL和rrs）进行了测序，并鉴定出了特定突变。
结论
本研究表明，EAI菌株具有高度传染性，并且在2000年至2008年期间，台湾高雄地区MTB对链霉素的耐药性有所增加。
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