Siva Kumar S, Ashok Kumar S, Sekar Gomathi, Devika K, Bhasker M, Sriram S, Dolla C K, Menon Pradeep Aravindan, Tripathy Srikanth Prasad, Narayanan P R, Ranganathan Uma Devi, Narayanan Sujatha, Mondal Rajesh
Department of Bacteriology, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Department of Epidemiology, ICMR-National Institute for Research in Tuberculosis, Chennai, India.
Int J Microbiol. 2020 Oct 14;2020:8841512. doi: 10.1155/2020/8841512. eCollection 2020.
Geographically, most tuberculosis (TB) cases in 2018 were reported from India. This TB burden is compounded by MDR-TB and XDR-TB. The strategies for the management and control of TB in the community depend on an understanding of the mode of spread of the different strains of TB isolates in the community. To determine the distribution and trends of strains over the time period in the community due to treatment, we carried out the present study on changes over two decades. . A total of 1218 isolates (year: 2001-2018) from Tiruvallur, India, were genotyped by spoligotyping after DNA extraction and subjected to anti-TB drug susceptibility testing for the first-line anti-TB drugs. . On analysis with the SpolDB4 database, majority (2001-2003: 53.32% and 2015-2018: 46.3%) of the isolates belonged to East African Indian (EAI) lineage, and the orphans designated in comparison to SpolDB4 stood 33% among 2001-2003 strain collection and 46.3% among 2015-2018 strain collection. 10.2% (2001-2003) and 9.26% (2015 to 2018) of isolates were monoresistant to isoniazid (H). MDR strains were less common among EAI strains (3.2%) compared to non-EAI strains (10.32%). . EAI is the most predominant lineage in Tiruvallur, despite the presence of highly transmissible lineages like Beijing for the last two decades. The prevalence of MDR-TB is below the national average of 2-3% among the new TB cases in the last two decades. The reason can be attributed to the well-established nature of the locally circulating strains in this region which are not associated with drug resistance.
从地理分布来看，2018年报告的大多数结核病病例来自印度。耐多药结核病和广泛耐药结核病使该国的结核病负担更加沉重。社区结核病管理和控制策略取决于对社区中不同结核分枝杆菌分离株传播方式的了解。为了确定社区中因治疗导致的结核分枝杆菌菌株随时间的分布和趋势，我们开展了这项关于二十年变化的研究。从印度蒂鲁瓦勒尔共收集了1218株分离株（年份：2001 - 2018年），提取DNA后进行间隔寡核苷酸分型（spoligotyping）基因分型，并对一线抗结核药物进行抗结核药物敏感性测试。通过SpolDB4数据库分析，大多数分离株（2001 - 2003年：53.32%；2015 - 2018年：46.3%）属于东非 - 印度（EAI）谱系，与SpolDB4相比的孤儿株在2001 - 2003年菌株收集中占33%，在2015 - 2018年菌株收集中占46.3%。10.2%（2001 - 2003年）和9.26%（2015 - 2018年）的分离株对异烟肼（H）单耐药。与非EAI菌株（10.32%）相比，耐多药菌株在EAI菌株中较少见（3.2%）。尽管在过去二十年中存在如北京家族等高传播性谱系，但EAI仍是蒂鲁瓦勒尔最主要的谱系。在过去二十年中，新结核病病例中耐多药结核病的患病率低于全国平均水平2 - 3%。原因可归因于该地区本地流行菌株的稳定性，这些菌株与耐药性无关。
