Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
CIBER Enfermedades Respiratorias, (CIBERES), Spain.
Sci Rep. 2020 Feb 17;10(1):2704. doi: 10.1038/s41598-020-59373-w.
It is relevant to evaluate MDR-tuberculosis in prisons and its impact on the global epidemiology of this disease. However, systematic molecular epidemiology programs in prisons are lacking. A health-screening program performed on arrival for inmates transferred from Peruvian prisons to Spain led to the diagnosis of five MDR-TB cases from one of the biggest prisons in Latin America. They grouped into two MIRU-VNTR-clusters (Callao-1 and Callao-2), suggesting a reservoir of two prevalent MDR strains. A high-rate of overexposure was deduced because one of the five cases was coinfected by a pansusceptible strain. Callao-1 strain was also identified in 2018 in a community case in Spain who had been in the same Peruvian prison in 2002-5. A strain-specific-PCR tailored from WGS data was implemented in Peru, allowing the confirmation that these strains were currently responsible for the majority of the MDR cases in that prison, including a new mixed infection.
评估监狱中的耐多药结核病及其对该病全球流行病学的影响十分重要。然而，监狱中缺乏系统的分子流行病学规划。对从秘鲁监狱转移到西班牙的囚犯进行抵达时的健康筛查，发现了五例耐多药结核病病例，这些病例均来自拉丁美洲最大的监狱之一。它们分为两个 MIRU-VNTR 簇（卡亚俄-1 和卡亚俄-2），表明存在两种流行的耐多药菌株的储存库。因为五例病例之一同时感染了一种普遍敏感的菌株，因此推断存在高度的过度暴露。卡亚俄-1 菌株也于 2018 年在西班牙的社区病例中被发现，该病例曾于 2002-2005 年在同一秘鲁监狱服刑。根据 WGS 数据定制的菌株特异性-PCR 在秘鲁实施，证实这些菌株目前是该监狱中大多数耐多药病例的罪魁祸首，包括新的混合感染。
