Zaniani Fatemeh Riyahi, Moghim Sharareh, Esfahani Bahram Nasr
Department of Microbiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2018 Feb 16;7:23. doi: 10.4103/2277-9175.225594. eCollection 2018.
Increasing drug resistance is an important factor in the complexity of tuberculosis (TB) control. The identification of disease transmission type, recurrence of a previous infection, or new transmission of the disease is the key factor in the control of TB. In this study, we aimed to identify the genetic diversity of drug-resistant isolates in Isfahan province of Iran through the mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing method based on 24 loci.
Of 300 isolates obtained from a variety of clinical specimens, 18 drug-resistance clinical isolates (resistant to a single drug to more than one drug) were collected between 2013 and 2015 from regional TB reference laboratory in Isfahan. All drug-resistance isolates were typed by 24-locus MIRU-VNTR typing.
The highest percentage of isolates, 38.8%, belonged to the East-Asian lineage (lineage 2), while the lineages Indo-Oceanic (lineage 1), East-African-Indian (lineage 3), and Euro-American (lineage 4) represented 5.5%, 22.2%, and 33.3%, respectively. Among the 33.3% (6/18) Euro-American strains, the Latin American- Mediterranean and Ural sub-lineage were 22.2% (4/18) and 11.1% (2/18), respectively.
The results of this study show that the lineages of drug-resistant isolates in Isfahan province of Iran are similar to those reported in the Eastern Mediterranean region (indicative of the epidemiological relationship between the countries in the region). Continued molecular monitoring is important as it has been proposed that the genetics and evolutionary backgrounds of drug-resistant strains may have an impact on the transmissibility profile.
耐药性增加是结核病(TB)控制复杂性的一个重要因素。确定疾病传播类型、既往感染复发或疾病新传播是结核病控制的关键因素。在本研究中,我们旨在通过基于24个位点的分枝杆菌散布重复单位-可变数目串联重复序列(MIRU-VNTR)分型方法,确定伊朗伊斯法罕省耐药菌株的遗传多样性。
从各种临床标本中获得300株菌株,2013年至2015年期间从伊斯法罕地区结核病参考实验室收集了18株耐药临床分离株(对一种药物耐药至对多种药物耐药)。所有耐药分离株均采用24位点MIRU-VNTR分型。
分离株中比例最高的为东亚谱系(谱系2),占38.8%,而印度洋谱系(谱系1)、东非-印度谱系(谱系3)和欧美谱系(谱系4)分别占5.5%、22.2%和33.3%。在33.3%(6/18)的欧美菌株中,拉丁美洲-地中海和乌拉尔亚谱系分别占22.2%(4/18)和11.1%(2/18)。
本研究结果表明,伊朗伊斯法罕省耐药分离株的谱系与东地中海地区报告的谱系相似(表明该地区各国之间的流行病学关系)。持续的分子监测很重要,因为有人提出耐药菌株的遗传和进化背景可能会对传播特征产生影响。