Wamala Dan, Okee Moses, Kigozi Edgar, Couvin David, Rastogi Nalin, Joloba Moses, Kallenius Gunilla
Department of Pathology, Mulago Hospital and Makerere University College of Health Sciences, P. O. Box 7072, Kampala, Uganda.
Department of Clinical Sciences and Education, Sodersjukhuset. Karolinska Institute, 171 77, Stockholm, Sweden.
BMC Res Notes. 2015 Sep 1;8:398. doi: 10.1186/s13104-015-1362-y.
In Uganda, the emerging Uganda genotype of Mycobacterium tuberculosis is the most common cause of pulmonary tuberculosis (PTB), and accounts for up to 70% of isolates. Extrapulmonary TB (EPTB) is less studied in Uganda.
Molecular characterization using deletion analysis and spoligotyping was performed on 121 M. tuberculosis isolates from lymph node fine needle biopsy aspirates of Ugandan patients with tuberculous lymphadenitis. The evolutionary relationships and worldwide distribution of the spoligotypes were analyzed.
Mycobacterium tuberculosis was the only cause of EPTB in this study. The T2 sublineage was the most predominant lineage and the Uganda genotype was the dominant genotype. There were 54 spoligotype patterns among the 121 study isolates. The dominant spoligotypes were shared international types (SIT) SIT420, SIT53, SIT 135, SIT 128 and SIT590 in descending order. All but SIT420 were previously reported in pulmonary TB in this setting. The phylogenetic analysis showed a long descendant branch of spoligotypes belonging to the T2-Uganda sublineage containing specifically SITs 135, 128 and 420.
In most cases, the spoligotypes were similar to those causing PTB, but the Uganda genotype was found to be less common in EPTB than previously reported for PTB in Uganda. The phylogenetic analysis and the study of the worldwide distribution of clustered spoligotypes indicate an ongoing evolution of the Uganda genotype, with the country of Uganda at the center of this evolution.
在乌干达，新兴的结核分枝杆菌乌干达基因型是肺结核（PTB）最常见的病因，占分离株的70%。乌干达对肺外结核（EPTB）的研究较少。
对121株来自乌干达结核性淋巴结炎患者淋巴结细针穿刺活检吸出物的结核分枝杆菌分离株进行缺失分析和间隔寡核苷酸分型（spoligotyping）分子特征分析。分析了间隔寡核苷酸分型的进化关系和全球分布。
本研究中结核分枝杆菌是EPTB的唯一病因。T2亚系是最主要的亚系，乌干达基因型是主要基因型。121株研究分离株中有54种间隔寡核苷酸分型模式。主要的间隔寡核苷酸分型依次为共享国际型（SIT）SIT420、SIT53、SIT 135、SIT 128和SIT590。除SIT420外，其他在该地区的肺结核中均有报道。系统发育分析显示，属于T2 - 乌干达亚系的间隔寡核苷酸分型有一个长的后代分支，其中特别包含SITs 135、128和420。
在大多数情况下，间隔寡核苷酸分型与导致PTB的分型相似，但发现乌干达基因型在EPTB中比之前乌干达PTB报道的情况更少见。系统发育分析和聚集性间隔寡核苷酸分型的全球分布研究表明，乌干达基因型正在持续进化，乌干达处于这一进化的中心。
