Medical Research Council Unit The Gambia at The London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, PO Box 273, Banjul, The Gambia.
Division of Microbiology & Immunity, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
Sci Rep. 2020 Jan 15;10(1):327. doi: 10.1038/s41598-019-56001-0.
In recent years Bamako has been faced with an emerging threat from multidrug resistant TB (MDR-TB). Whole genome sequence analysis was performed on a subset of 76 isolates from a total of 208 isolates recovered from tuberculosis patients in Bamako, Mali between 2006 and 2012. Among the 76 patients, 61(80.3%) new cases and 15(19.7%) retreatment cases, 12 (16%) were infected by MDR-TB. The dominant lineage was the Euro-American lineage, Lineage 4. Within Lineage 4, the Cameroon genotype was the most prevalent genotype (n = 20, 26%), followed by the Ghana genotype (n = 16, 21%). A sub-clade of the Cameroon genotype, which emerged ~22 years ago was likely to be involved in community transmission. A sub-clade of the Ghana genotype that arose approximately 30 years ago was an important cause of MDR-TB in Bamako. The Ghana genotype isolates appeared more likely to be MDR than other genotypes after controlling for treatment history. We identified a clade of four related Beijing isolates that included one MDR-TB isolate. It is a major concern to find the Cameroon and Ghana genotypes involved in community transmission and MDR-TB respectively. The presence of the Beijing genotype in Bamako remains worrying, given its high transmissibility and virulence.
近年来，巴马科面临着耐多药结核病（MDR-TB）的新威胁。对 2006 年至 2012 年间在马里巴马科从结核病患者中采集的 208 株分离株中的 76 株进行了全基因组序列分析。在 76 名患者中，61 名（80.3%）为新发病例，15 名（19.7%）为复治病例，12 名（16%）感染了耐多药结核病。主要谱系是欧亚谱系，谱系 4。在谱系 4 中，喀麦隆基因型最为普遍（n=20，26%），其次是加纳基因型（n=16，21%）。喀麦隆基因型的一个亚系，大约 22 年前出现，可能与社区传播有关。大约 30 年前出现的加纳基因型亚系是巴马科耐多药结核病的重要原因。在控制治疗史的情况下，加纳基因型分离株比其他基因型更有可能成为耐多药。我们鉴定了包含一株耐多药结核病分离株的四个相关北京分离株的一个分支。喀麦隆和加纳基因型分别参与社区传播和耐多药结核病，这是一个主要的关注点。考虑到北京基因型的高传染性和毒力，其在巴马科的存在仍然令人担忧。
