Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, PR China; Department of Chronic Communicable Disease, Center for Disease Control and Prevention of Jiangsu Province, Nanjing, PR China.
Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, PR China.
Clin Microbiol Infect. 2020 Feb;26(2):180-188. doi: 10.1016/j.cmi.2019.07.016. Epub 2019 Jul 20.
The Mycobacterium tuberculosis Beijing genotype was first described in 1995 and is now the predominant strain among patients with tuberculosis in many Asian countries. The rapid global spread of the Beijing genotype is receiving increasing attention because it can cause a higher risk of treatment failures. Our objective was to assess the association between the Beijing genotype and unfavourable treatment outcomes of tuberculosis.
We searched for eligible studies through PubMed, Web of Science, Chinese National Knowledge Infrastructure and Wanfang Data. We included cohort studies that evaluated treatment outcomes and Beijing genotype strains. Participants were individuals with active pulmonary tuberculosis. The association between Beijing genotype and the risk of unfavourable treatment outcomes was assessed using the pooled odds ratios (ORs) with corresponding confidence intervals (CIs).
In total, 7489 tuberculosis patients were involved in the analysis. Patients infected with the Beijing genotype were more likely to have unfavourable treatment outcomes, with the OR of 2.04 (95% CI 1.52-2.75). The pooled OR was 2.33 (95% CI 1.71-3.16) for recurrence, 2.36 (95% CI 1.69-3.30) for relapse and 2.62 (95% CI 1.90-3.61) for treatment failure, respectively. Subgroup analysis revealed that Beijing genotype was a significant risk factor for unfavourable treatment outcomes in Asians (OR 2.28, 95% CI 1.82-2.86) or in drug-susceptible TB patients (OR 2.11, 95% CI 1.31-3.39). No significant association was observed among non-Asian populations (OR 1.17, 95% CI 0.73-1.86) or patients with multidrug-resistant (MDR) tuberculosis (OR 0.97, 95% CI 0.48-1.94).
Our results suggest that Mycobacterium tuberculosis Beijing genotype is associated with an increased risk of unfavourable treatment outcomes, including treatment failure and relapse.
结核分枝杆菌北京基因型于 1995 年首次被描述，目前是亚洲许多国家结核病患者中的主要菌株。北京基因型的快速全球传播引起了越来越多的关注，因为它可能导致治疗失败的风险增加。我们的目的是评估北京基因型与结核病治疗结局不良之间的关联。
我们通过 PubMed、Web of Science、中国知网和万方数据检索了符合条件的研究。我们纳入了评估治疗结局和北京基因型菌株的队列研究。参与者为患有活动性肺结核的个体。使用合并优势比（ORs）及其置信区间（CIs）评估北京基因型与不良治疗结局风险之间的关联。
共有 7489 例结核病患者纳入分析。感染北京基因型的患者更有可能出现不良治疗结局，其 OR 为 2.04（95%CI 1.52-2.75）。复发的合并 OR 为 2.33（95%CI 1.71-3.16），复发的合并 OR 为 2.36（95%CI 1.69-3.30），治疗失败的合并 OR 为 2.62（95%CI 1.90-3.61）。亚组分析显示，北京基因型是亚洲人群（OR 2.28，95%CI 1.82-2.86）或耐多药结核病患者（OR 2.11，95%CI 1.31-3.39）不良治疗结局的显著危险因素。在非亚洲人群（OR 1.17，95%CI 0.73-1.86）或耐多药结核病患者（OR 0.97，95%CI 0.48-1.94）中未观察到显著关联。
我们的研究结果表明，结核分枝杆菌北京基因型与不良治疗结局风险增加相关，包括治疗失败和复发。
