Department of Orthopedics, The Third Affiliated Hospital of Chongqing Medical University (Gener Hospital), No. 1, Shuanghu Branch Road, Yubei District, Chongqing, 401120, China.
Department of Clinical Laboratory, Public Health Medical Center, No. 109, Baoyu Road, Shapingba District, Chongqing, 400036, China.
BMC Infect Dis. 2018 Nov 14;18(1):565. doi: 10.1186/s12879-018-3503-0.
By 2014 although tuberculosis (TB) incidence had fallen by an average of 1.5% per year since 2000 and was 18% lower than the level of in 2000, 1.5 million people died for TB in that year. One of reason was that drug resistant Mycobacterium tuberculosis (DRTB) spread. This study aims to determine drug resistant characteristics and genotype of DRTB that isolated from patients in a tuberculosis referral hospital of southwest China.
Five hundred thirty-eight drug resistant tuberculosis samples were collected from July 2013 to March 2015. All the isolates were identified by genomic deletions in region of difference 105 (RD105) and genotyped by mycobacterial interspersed repetitive unit-variable number tandem repeat typing (MIRU-VNTR). Polymorphism and cluster analysis of each locus was carried out using Bionumerics Version 3.0 and phyloviz software.
Five hundred thirty-eight TB strains included 503 Mycobacterium tuberculosis (MTB) isolates and 35 non Mycobacterium tuberculosis (NMTB) isolates. Of 503 isolates Beijing family type was 447 (88.9%, 447/503) and non-Beijing family type was 56 (11.1%, 56/503). Five hundred three DRTB isolates were divided into 345 genotypes, of which 265 isolates were single genotype and the remaining 238 strains were classified into 80 clusters with cluster rate of 47.3% and cluster ratio of 31.4%. Sixty-nine clusters belonged to Beijing family with cluster rate was 48.3% and clustering ratio was 32.9%. The non - Beijing family had 11 clusters with a cluster rate of 39.3% and the clustering ratio of 19.6%. Beijing genotype had a significant correlation with the age (P < 0.05), the retreatment patients (P < 0.05) and the city of Chongqing (P < 0.05), not with gender (P > 0.05). In the 9 Beijing genotype clusters each cluster contained some patients who lived in the same region.
Beijing genotype was the predominant in the patients with DRTB in our hospital. In Chongqing retreatment patients with Beijing genotype MTB may be patient with DRTB. Drug resistance test (DST), regular medication and strict follow-up are very important for patients with Beijing genotype MTB. In Chongqing control and treatment of DRTB should be paid attention. Transmission and relations of patients with DRTB need to be further research.
尽管自 2000 年以来，结核病（TB）的发病率平均每年下降 1.5%，比 2000 年的水平低 18%，但 2014 年仍有 150 万人死于结核病。原因之一是耐药结核分枝杆菌（DRTB）的传播。本研究旨在确定从中国西南地区一家结核病转诊医院的患者中分离出的 DRTB 的耐药特征和基因型。
2013 年 7 月至 2015 年 3 月，共收集了 538 例耐药结核病样本。所有分离株均通过基因组差异 105 区（RD105）缺失鉴定，并通过分枝杆菌插入重复单元-可变数串联重复分型（MIRU-VNTR）进行基因分型。使用 Bionumerics Version 3.0 和 phyloviz 软件对每个位点的多态性和聚类进行分析。
538 株结核菌株包括 503 株结核分枝杆菌（MTB）分离株和 35 株非结核分枝杆菌（NMTB）分离株。447 株（88.9%，447/503）为北京家族型，56 株（11.1%，56/503）为非北京家族型。503 株 DRTB 分离株分为 345 种基因型，其中 265 株为单基因型，其余 238 株分为 80 个克隆群，克隆率为 47.3%，克隆比为 31.4%。69 个克隆群属于北京家族，克隆率为 48.3%，聚类比为 32.9%。非北京家族有 11 个克隆群，克隆率为 39.3%，聚类比为 19.6%。北京基因型与年龄（P<0.05）、复治患者（P<0.05）和重庆市（P<0.05）显著相关，与性别无关（P>0.05）。在 9 个北京基因型克隆群中，每个克隆群都包含一些居住在同一地区的患者。
北京基因型是我院 DRTB 患者的主要基因型。在重庆，复治患者中携带北京基因型 MTB 可能是 DRTB 患者。耐药性检测（DST）、规范用药和严格随访对北京基因型 MTB 患者非常重要。重庆应注意 DRTB 的控制和治疗。需要进一步研究 DRTB 患者的传播和关系。
