Skiba Yuriy, Mokrousov Igor, Ismagulova Gulnara, Maltseva Elina, Yurkevich Nadezhda, Bismilda Venera, Chingissova Lyailya, Abildaev Tleuhan, Aitkhozhina Nagima
Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan.
St. Petersburg Pasteur Institute, St. Petersburg, Russia.
Tuberculosis (Edinb). 2015 Sep;95(5):538-46. doi: 10.1016/j.tube.2015.04.012. Epub 2015 May 14.
Republic of Kazakhstan is among the 27 high multidrug-resistant tuberculosis (MDR-TB) burden countries in the world. Here, we analyzed the population structure and phylogeography of Mycobacterium tuberculosis in Kazakhstan and impact of the identified genotypes on spread of drug resistant strains. A total of 159 M. tuberculosis isolates from different regions of Kazakhstan were typed using 24-MIRU-VNTR and spoligotyping, and the profiles were compared to the MIRU-VNTRplus and SITVIT_WEB databases. Eight isolates with double VNTR alleles were excluded from further analysis that was performed on 151 isolates. They were assigned to 10 families, Beijing (n = 109) being the largest and dominated by a single clonal cluster 94-32 and derived profiles (n = 101). The other families were represented mainly by LAM (n = 17), Ural (n = 8), NEW-1 (n = 3) and a new cluster named KAZ-1 (n = 8). Beijing, LAM and Ural isolates were detected in all parts of the country while Iran-specific family NEW-1 was found only in southern Kazakhstan (P = 0.001). A reduced scheme of 10 most polymorphic VNTR loci provided a discrimination similar to that achieved by 15-MIRU scheme and may be recommended for rapid preliminary screening of the clinical isolates in Kazakhstan. Multi-drug resistance was significantly more prevalent among Beijing (64/109) and LAM (7/17) strains compared to strains of other families (1/25; P = 0.0006 and 0.01, respectively). High prevalence of the genetically closely related MDR strains of the Beijing genotype found in different regions of Kazakhstan highlights their crucial impact on the current TB epidemic in this country.
哈萨克斯坦共和国是世界上27个耐多药结核病负担较重的国家之一。在此，我们分析了哈萨克斯坦结核分枝杆菌的种群结构和系统地理学，以及所鉴定基因型对耐药菌株传播的影响。使用24-MIRU-VNTR和间隔寡核苷酸分型技术对来自哈萨克斯坦不同地区的159株结核分枝杆菌进行分型，并将分型结果与MIRU-VNTRplus和SITVIT_WEB数据库进行比较。8株具有双VNTR等位基因的菌株被排除在进一步分析之外，后续分析基于151株菌株进行。它们被分为10个家族，其中北京家族（n = 109）最大，以单一克隆簇94-32及其衍生型（n = 101）为主。其他家族主要由LAM家族（n = 17）、乌拉尔家族（n = 8）、NEW-1家族（n = 3）和一个名为KAZ-1的新簇（n = 8）代表。北京、LAM和乌拉尔家族的菌株在该国各地均有检出，而伊朗特有的NEW-1家族仅在哈萨克斯坦南部发现（P = 0.001）。10个最具多态性的VNTR位点的简化方案提供了与15-MIRU方案相似的鉴别能力，可推荐用于哈萨克斯坦临床分离株的快速初步筛查。与其他家族的菌株（1/25；P分别为0.0006和0.01）相比，北京家族（64/109）和LAM家族（7/17）的菌株中耐多药情况更为普遍。在哈萨克斯坦不同地区发现的北京基因型的遗传密切相关的耐多药菌株的高流行率凸显了它们对该国当前结核病流行的关键影响。
