Division of Infectious Diseases and Global Medicine, University of Florida, College of Medicine, 2055 Mowry Road, P.O. Box 103600, Gainesville, FL 32610, USA; Emerging Pathogen Institute, University of Florida, 2055 Mowry Road, P.O. Box 100009, Gainesville, FL 32610, USA.
Florida Department of Health, Bureau of Public Health Laboratories, 1217 N. Pearl Street, Jacksonville, FL, 32202, USA.
Infect Genet Evol. 2017 Nov;55:366-371. doi: 10.1016/j.meegid.2017.10.004. Epub 2017 Oct 7.
Mycobacterium tuberculosis is characterized into four global lineages with strong geographical restriction. To date one study in the United States has investigated M. tuberculosis lineage association with tuberculosis (TB) disease presentation (extra-pulmonary versus pulmonary). We update this analysis using recent (2009-2015) data from the State of Florida to measure lineage association with pulmonary TB, the infectious form of the disease.
M. tuberculosis lineage was assigned based on the spacer oligonucleotide typing (spoligotyping) patterns. TB disease site was defined as exclusively pulmonary or extra-pulmonary. We used ORs to measure the association between M. tuberculosis lineages and pulmonary compared to extra-pulmonary TB. The final multivariable model was adjusted for patient socio-demographics, HIV and diabetes status.
We analyzed 3061 cases, 83.4% were infected with a Euro-American lineage, 8.4% Indo-Oceanic and 8.2% East-Asian lineage. The majority of the cases (86.0%) were exclusively pulmonary. Compared to the Indo-Oceanic lineage, infection with a Euro-American (AOR=1.87, 95% CI: 1.21, 2.91) or an East-Asian (AOR=2.11, 95% CI: 1.27, 3.50) lineage favored pulmonary disease compared to extra-pulmonary. In a sub-analysis among pulmonary cases, strain lineage was not associated with sputum smear positive status, indicating that the observed association with pulmonary disease is independent of host contagiousness.
As an obligate pathogen, M. tuberculosis' fitness is directly correlated to its transmission potential. In this analysis, we show that M. tuberculosis lineage is associated with pulmonary disease presentation. This association may explain the predominance in a region of certain lineages compared to others.
结核分枝杆菌（Mycobacterium tuberculosis）分为四个具有强烈地域限制的全球谱系。迄今为止，美国的一项研究调查了结核分枝杆菌谱系与结核病（TB）疾病表现（肺外与肺内）的关联。我们使用佛罗里达州的最新（2009-2015 年）数据更新了这项分析，以衡量谱系与肺内 TB（疾病的传染性形式）的关联。
根据间隔寡核苷酸分型（ spoligotyping ）模式来确定结核分枝杆菌谱系。TB 疾病部位定义为仅肺内或肺外。我们使用 OR 来衡量结核分枝杆菌谱系与肺内与肺外 TB 之间的关联。最终的多变量模型调整了患者的社会人口统计学、HIV 和糖尿病状况。
我们分析了 3061 例病例，83.4%感染了欧亚谱系，8.4%感染了印度-太平洋谱系，8.2%感染了东亚谱系。大多数病例（86.0%）仅为肺内。与印度-太平洋谱系相比，感染欧亚谱系（AOR=1.87，95%CI：1.21，2.91）或东亚谱系（AOR=2.11，95%CI：1.27，3.50）更有利于肺内疾病，而不是肺外疾病。在肺内病例的亚分析中，菌株谱系与痰涂片阳性状态无关，表明观察到的与肺内疾病的关联独立于宿主的传染性。
作为一种专性病原体，结核分枝杆菌的适应性与其传播潜力直接相关。在这项分析中，我们表明结核分枝杆菌谱系与肺内疾病表现有关。这种关联可能解释了在一个地区中某些谱系相对于其他谱系的优势。
