Cannas Angela, Mazzarelli Antonio, Di Caro Antonino, Delogu Giovanni, Girardi Enrico
National Institute for Infectious Diseases L. Spallanzani , Rome, Italy.
National Institute for Infectious Diseases L. Spallanzani, Rome, Italy; Institute of Microbiology, Sacro Cuore Catholic University, Rome, Italy.
Infect Dis Rep. 2016 Jun 24;8(2):6567. doi: 10.4081/idr.2016.6567.
Tuberculosis (TB) is still an important cause of morbidity and mortality worldwide. An improvement of the strategies for disease control is necessary in both low- and high-incidence TB countries. Clinicians, epidemiologists, laboratory specialists, and public health players should work together in order to achieve a significant reduction in TB transmission and spread of drug-resistant strains. Effective TB surveillance relies on early diagnosis of new cases, appropriate therapy, and accurate detection of outbreaks in the community, in order to implement proper TB control strategies. To achieve this goal, information from classical and molecular epidemiology, together with patient clinical data need to be combined. In this review, we summarize the methodologies currently used in molecular epidemiology, namely molecular typing. We will discuss their efficiency to phylogenetically characterize Mycobacterium tuberculosis isolates, and their ability to provide information that can be useful for disease control. We will also introduce next generation sequencing as the methodology that potentially could provide in a short time both, detection of new outbreaks and identification of resistance patterns. This could envision a potential of next generation sequencing as an important tool for accurate patient management and disease control.
结核病（TB）仍然是全球发病和死亡的重要原因。在结核病低发和高发国家，改进疾病控制策略都是必要的。临床医生、流行病学家、实验室专家和公共卫生工作者应共同努力，以显著减少结核病的传播和耐药菌株的扩散。有效的结核病监测依赖于新病例的早期诊断、适当的治疗以及社区中疫情爆发的准确检测，以便实施适当的结核病控制策略。为实现这一目标，需要将经典流行病学和分子流行病学信息与患者临床数据相结合。在本综述中，我们总结了目前分子流行病学中使用的方法，即分子分型。我们将讨论它们在系统发育上表征结核分枝杆菌分离株的效率，以及它们提供对疾病控制有用信息的能力。我们还将介绍下一代测序技术，该技术有可能在短时间内同时检测新的疫情爆发和识别耐药模式。这可以预见下一代测序技术作为准确患者管理和疾病控制重要工具的潜力。
