Cheng Aristine, Sun Hsin-Yun, Tsai Yi-Tzu, Lu Po-Liang, Lee Susan Shin-Jung, Lee Yi-Tzu, Wang Yung-Chih, Liu Po-Yu, Chien Jung-Yien, Hsueh Po-Ren, Chang Shu-Yuan, Wu Un-In, Sheng Wang-Huei, Chen Yee-Chun, Chang Shan-Chwen
Dept of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
College of Medicine, National Taiwan University, Taipei, Taiwan.
ERJ Open Res. 2021 Jan 18;7(1). doi: 10.1183/23120541.00191-2020. eCollection 2021 Jan.
(MAB) has emerged as the predominant pulmonary non-tuberculous mycobacterial pathogen in parts of Asia, including Taiwan. The reasons for the significant increase in MAB infections in the non-cystic fibrosis (CF) populations are poorly understood. The study aimed to elucidate whether this increase is related to the spread of the globally successful clone of MAB.
We performed multilocus sequence typing of 371 nonduplicated MAB pulmonary isolates from 371 patients sampled between 2010-2017 at seven hospitals across Taiwan.
In total, 183 (49.3%) isolates were subsp. (MAB-a), 187 (50.4%) were subsp. (MAB-m), and 1 (0.3%) was subsp. (MAB-b). MAB-a sequence type (ST)1 (23.7%) and ST127 (3.8%), followed by MAB-m ST48 (16.2%), ST117 (15.1%), ST23 (8.6%) were most common overall. Of MAB-a strains, 50 (27.3%) belonged to novel STs and 38 (10.2%) were singleton strains, while of MAB-m strains, only 10 (5.3%) were novel and 8 (2.2%) were singletons. From 2010 to 2017, the frequency of the historically dominant ST1 declined from 28.6% to 22.5%, whereas the recently emerged globally successful clonal cluster 3, ST23 and ST48, increased from 14.3% to 40.0%.
The dominance of ST1 particularly in the last 2 years of this study appears to be declining, while ST23, reported in outbreaks among CF and post-surgical cohorts across the Americas and Europe, alongside the closely related ST48, is present among non-CF populations in Taiwan. These trends need to be confirmed with further ongoing studies to track the molecular epidemiology of clinical MAB isolates worldwide.
在包括台湾在内的亚洲部分地区，脓肿分枝杆菌（MAB）已成为主要的肺部非结核分枝杆菌病原体。非囊性纤维化（CF）人群中MAB感染显著增加的原因尚不清楚。本研究旨在阐明这种增加是否与全球成功流行的MAB克隆株的传播有关。
我们对2010年至2017年间从台湾七家医院采集的371例患者的371株非重复MAB肺部分离株进行了多位点序列分型。
总共183株（49.3%）分离株为脓肿分枝杆菌脓肿亚种（MAB-a），187株（50.4%）为脓肿分枝杆菌马赛亚种（MAB-m），1株（0.3%）为脓肿分枝杆菌博列亚种（MAB-b）。总体而言，MAB-a序列型（ST）1（23.7%）和ST127（3.8%）最为常见，其次是MAB-m ST48（16.2%）、ST117（15.1%）、ST23（8.6%）。在MAB-a菌株中，50株（27.3%）属于新的ST型，38株（10.2%）为单态菌株；而在MAB-m菌株中，只有10株（5.3%）是新的，8株（2.2%）是单态的。从2010年到2017年，历史上占主导地位的ST1的频率从28.6%下降到22.5%，而最近出现的全球成功克隆簇3、ST23和ST48从14.3%增加到40.0%。
在本研究的最后两年中，尤其是ST1的主导地位似乎在下降，而在美洲和欧洲的CF患者群体及术后队列的暴发中报道的ST23，以及与之密切相关的ST48，在台湾的非CF人群中也存在。这些趋势需要通过进一步的研究来证实，以便追踪全球临床MAB分离株的分子流行病学。
