赞比亚卢萨卡地区结核分枝杆菌基因型特征及其与耐多药的相关性研究。

Characterization of Mycobacterium tuberculosis genotypes and their correlation to multidrug resistance in Lusaka, Zambia.

机构信息

Department of Pathology and Microbiology, University Teaching Hospital, RW 1X, Ministry of Health, Lusaka, Zambia.

Division of Bioresources, Hokkaido University Research Center for Zoonosis Control, Sapporo, Japan; International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan.

出版信息

Int J Infect Dis. 2021 Jan;102:489-496. doi: 10.1016/j.ijid.2020.10.014. Epub 2020 Oct 12.

DOI:10.1016/j.ijid.2020.10.014

PMID:33059094

Abstract

OBJECTIVES

The burden of multidrug-resistant tuberculosis (MDR-TB) has been reported to be increasing in Zambia. The reasons for the increase are still unclear. This study determined the diversity of Mycobacterium tuberculosis genotypes among isolates in Lusaka, the capital city, and investigated their association with MDR-TB.

METHODS

Spoligotyping, large sequence polymorphism (LSP) analysis, and sequencing of MDR associated genes were performed on a total of 274 M. tuberculosis clinical isolates stored at the University Teaching Hospital from 2013 to 2017. Of these, 134 were MDR-TB while 126 were pan-susceptible.

RESULTS

Spoligotyping showed the LAM family as the most predominant genotype (149/274, 54.4%) followed by the CAS family (44/274, 16.1%), T family (39/274, 14.2%), and minor proportions of X, S, Harleem, EAI and Beijing spoligofamilies were identified. Three M. bovis isolates were also observed. Among those, CAS1-Kili (SIT 21) and LAM1 (SIT 20) subfamilies showed a propensity for MDR-TB with p = 0.0001 and p = 0.001, respectively.

CONCLUSIONS

This phenomenon might explain the future increase in the MDR-TB burden caused by specific lineages in Zambia. Therefore, it is recommended that the National TB control program in the country complements conventional control strategies with molecular analysis for monitoring and surveillance of MDR-TB epidemiology.

摘要

目的

据报道，赞比亚的耐多药结核病（MDR-TB）负担一直在增加。增加的原因尚不清楚。本研究旨在确定首都卢萨卡分离株中的结核分枝杆菌基因型多样性，并调查其与 MDR-TB 的关联。

方法

对 2013 年至 2017 年期间保存在大学教学医院的总共 274 株结核分枝杆菌临床分离株进行 spoligotyping、大片段序列多态性（LSP）分析和 MDR 相关基因测序。其中，134 株为 MDR-TB，126 株为全敏感株。

结果

spoligotyping 显示 LAM 家族是最主要的基因型（149/274，54.4%），其次是 CAS 家族（44/274，16.1%）、T 家族（39/274，14.2%），以及少量的 X、S、Harleem、EAI 和 Beijing spoligofamilies 型别。还观察到 3 株牛分枝杆菌分离株。其中，CAS1-Kili（SIT 21）和 LAM1（SIT 20）亚家族与 MDR-TB 呈正相关，p=0.0001 和 p=0.001。