区分来自泰国东北部患者的脓肿分枝杆菌的持续感染/定植与再感染/再定植。
Differentiation between persistent infection/colonization and re-infection/re-colonization of Mycobacterium abscessus isolated from patients in Northeast Thailand.
机构信息
Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Research and Diagnostic Center for Emerging Infectious Diseases, Khon Kaen University, Khon Kaen, Thailand.
Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
出版信息
Infect Genet Evol. 2019 Mar;68:35-42. doi: 10.1016/j.meegid.2018.12.001. Epub 2018 Dec 3.
Mycobacterium abscessus can cause true infection or be present in the host as a harmless colonist. The ability of M. abscessus to cause disease and develop drug resistance is known to have a genetic basis. We aimed to differentiate between persistent infection and reinfection using multilocus sequence typing (MLST) and to study the genetic diversity of M. abscessus relative to multi-organ infection and drug resistance in Northeast Thailand. DNA was extracted from 62 M. abscessus isolates (24 cases). The following genes were sequenced: argH, cya, glpK, gnd, murC, pta, purH and rpoB. Drug susceptibility tests were performed using broth microdilution. Subspecies classification and phylogeny were determined. Among the 24 cases (62 isolates), 19 cases (49 isolates) were of true NTM infection and 5 cases (13 isolates) examples of colonization. Two subspecies, M. abscessus subsp. massiliense (12 cases, 32 isolates) and M. abscessus subsp. abscessus (12 cases, 30 isolates) were identified. The major sequence type (ST) was ST227. Two clonal groups among patients were found; clonal cluster I (5 cases, 8 isolates) and clonal cluster II (2 cases, 4 isolates) but no epidemiological link was apparent. Reinfection (2 cases with different clones of M. abscessus strains; >9 SNPs different) and persistent infection (14 cases with the same clone; <6 SNPs) were distinguished based on a phylogeny. Based on these SNP cutoff values, 3 cases of persistent colonization (same strain through time) and 2 cases of re-colonization (different strains through time) were identified. M. abscessus subsp. abscessus was significantly associated with clarithromycin resistance (p < .001) and multi-organ infection (p = .03). Molecular epidemiology based on MLST can be used to differentiate between reinfection vs persistent infection, persistent colonization vs re-colonization. ST227 was the main epidemic strain in Northeast Thailand.
脓肿分枝杆菌可导致真正的感染，也可作为无害的定植菌存在于宿主中。已知脓肿分枝杆菌致病和产生耐药性的能力具有遗传基础。我们旨在通过多位点序列分型 (MLST) 区分持续性感染和再感染，并研究泰国东北部多器官感染和耐药性与脓肿分枝杆菌遗传多样性的关系。从 62 株脓肿分枝杆菌分离株（24 例）中提取 DNA。对以下基因进行测序：argH、cya、glpK、gnd、murC、pta、purH 和 rpoB。使用肉汤微量稀释法进行药敏试验。进行亚种分类和系统发育分析。在 24 例（62 株）中，19 例（49 株）为真正的非结核分枝杆菌感染，5 例（13 株）为定植。鉴定出 2 个亚种，脓肿分枝杆菌亚种马萨诸塞亚种（12 例，32 株）和脓肿分枝杆菌亚种脓肿亚种（12 例，30 株）。主要序列型（ST）为 ST227。在患者中发现了 2 个克隆群；克隆群 I（5 例，8 株）和克隆群 II（2 例，4 株），但没有明显的流行病学联系。基于系统发育，区分了再感染（2 例具有不同的脓肿分枝杆菌菌株克隆；>9 个 SNP 不同）和持续性感染（14 例具有相同的克隆；<6 个 SNP）。基于这些 SNP 截断值，确定了 3 例持续性定植（同一菌株随时间变化）和 2 例再定植（不同菌株随时间变化）。脓肿分枝杆菌亚种脓肿亚种与克拉霉素耐药显著相关（p<0.001）和多器官感染（p=0.03）。基于 MLST 的分子流行病学可用于区分再感染与持续性感染、持续性定植与再定植。ST227 是泰国东北部的主要流行株。
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