Departamento de Microbiología, Facultad de Medicina, Universidad Nacional de Colombia, Carrera 30 45 - 03, Facultad de Medicina, Edifcio 471, Bogotá, D.C, Colombia.
Grupo de Micobacterias, Red Nacional de Laboratorios, Instituto Nacional de Salud, Avenida calle 26 No. 51-20 - Zona 6 CAN, Bogotá, D.C, Colombia.
Tuberculosis (Edinb). 2020 Dec;125:102011. doi: 10.1016/j.tube.2020.102011. Epub 2020 Oct 17.
Emergence of multidrug-resistant (MDR) Mycobacterium tuberculosis complex (MTBC) isolates is a major public health problem that threatens progress made in tuberculosis (TB) care and control worldwide. In Colombia, the prevalence of MDR tuberculosis (MDR-TB) has increased slowly but steadily since 2001. However, the population structure of the MDR-TB strains circulating in Colombia is sparsely known. In this work, 203 MDR isolates isolated in 2012-2013 were collected, and characterized by spoligotyping, followed by 24-loci MIRU-VNTR (data available for 190 isolates). The most prevalent genotypes corresponded to SIT42/LAM9 (12.81%), SIT62/H1 (10.34%), and SIT190/Beijing (10.34%). A fine analysis showed that although the MDR strains came from 29 of the 33 departments of Colombia, the distribution of these main lineages was not at random and depended on the city of isolation (p-value <0.000001). Both LAM and Beijing lineage strains were significantly associated with MDR-TB (p-value <0.0001): LAM lineage was associated with 2 patterns of MDR, namely combined resistance to INH + Rifampin (HR), and to SHRE (Streptomycin + INH + Rifampin + Ethambutol), while the Beijing lineage strains were essentially associated with MDR (SHRE). Interestingly, distribution of genotypic lineages in function of drug resistance information (e.g. pansusceptible vs. MDR) was different in our setting as compared to other countries in Latin America. However, MIRU-VNTR patterns were unique for all strains, an observation that did not support active transmission of circulating MDR clones.
耐多药（MDR）结核分枝杆菌复合群（MTBC）分离株的出现是一个主要的公共卫生问题，威胁着全球结核病（TB）防治工作的进展。在哥伦比亚，自 2001 年以来，MDR 结核病（MDR-TB）的流行率一直在缓慢但稳步上升。然而，在哥伦比亚流行的 MDR-TB 菌株的种群结构知之甚少。在这项工作中，收集了 2012-2013 年分离的 203 株 MDR 分离株，通过 spoligotyping 进行了表征，随后进行了 24 位 MIRU-VNTR（可获得 190 株分离株的数据）。最常见的基因型对应于 SIT42/LAM9（12.81%）、SIT62/H1（10.34%）和 SIT190/Beijing（10.34%）。精细分析表明，尽管 MDR 菌株来自哥伦比亚的 33 个省中的 29 个，但这些主要谱系的分布并非随机，而是取决于分离城市（p 值<0.000001）。LAM 和 Beijing 谱系菌株与 MDR-TB 显著相关（p 值<0.0001）：LAM 谱系与 INH+Rifampin（HR）和 SHRE（链霉素+INH+Rifampin+乙胺丁醇）联合耐药的 2 种 MDR 模式相关，而 Beijing 谱系菌株主要与 MDR（SHRE）相关。有趣的是，在我们的研究中，根据耐药信息（例如全敏感与 MDR）对基因型谱系的分布与拉丁美洲其他国家不同。然而，所有菌株的 MIRU-VNTR 模式都是独特的，这一观察结果不支持循环 MDR 克隆的活跃传播。
