National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Respiratory Diseases Department of Nanlou, Chinese People's Liberation Army General Hospital, Beijing, China.
J Infect. 2015 Aug;71(2):231-7. doi: 10.1016/j.jinf.2015.03.012. Epub 2015 Apr 29.
Mixed infections have been considered as a potential obstacle for tuberculosis treatment and control. To date, few studies have been done to determine the rate of mixed infections of Mycobacterium tuberculosis in China.
In this study, we used the standard 24-loci MIRU-VNTR method to genotype the representative M. tuberculosis isolates from the national drug-resistant survey conducted in China. A total of 3248 M. tuberculosis complex (MTBC) strains had complete 24-loci MIRU-VNTR results and available for the analyses.
Overall, MIRU-VNTR typing identified 115 (3.5%) isolates as being mixed MTBC infections in China. Statistical analysis revealed that mixed infections were significantly more likely to occur in men than women. Compared with the percentage of mixed infection from patients aged 45-56 years, the percentages of mixed infections were higher among patients aged 25-44 years [OR (95% CI): 1.844(1.129-3.014)] and old patients [older than 65 years OR (95% CI): 1.908(1.097-3.319)]. In addition, significantly higher frequencies of hemoptysis (P = 0.022) and chest pain (P = 0.012) were observed among mixed infections, using patients infected with a single strain as a reference.
In conclusion, this study has provided the first comprehensive understanding of mixed MTBC infections in China, which will be essential to generate the effective TB control strategies.
混合感染被认为是结核病治疗和控制的潜在障碍。迄今为止，很少有研究确定中国结核分枝杆菌混合感染的发生率。
本研究采用标准的 24 位基因 MIRU-VNTR 方法对中国进行的全国耐药性调查中代表性结核分枝杆菌分离株进行基因分型。共有 3248 株结核分枝杆菌复合群（MTBC）菌株具有完整的 24 位基因 MIRU-VNTR 结果，可用于分析。
总体而言，MIRU-VNTR 分型在中国确定了 115 株（3.5%）混合 MTBC 感染的分离株。统计分析显示，混合感染在男性中比女性更常见。与 45-56 岁患者的混合感染比例相比，25-44 岁患者[比值比（95%置信区间）：1.844（1.129-3.014）]和老年患者（年龄大于 65 岁，比值比（95%置信区间）：1.908（1.097-3.319）]的混合感染比例更高。此外，与感染单株的患者相比，混合感染的咯血（P=0.022）和胸痛（P=0.012）频率显著更高。
总之，本研究首次全面了解了中国 MTBC 混合感染情况，这对于制定有效的结核病控制策略至关重要。
