Department of Laboratory Medicine, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan, 430030, China.
Department of Internal Medicine, Wuhan Institute for Tuberculosis Control, Wuhan Pulmonary Hospital, Wuhan, 430030, China.
BMC Infect Dis. 2022 Feb 26;22(1):192. doi: 10.1186/s12879-022-07188-7.
Drug-resistant tuberculosis (TB) continues to be a public health threat. There are few studies on transmission and genotyping of MDR-TB family households in China. This study aimed to investigate transmission of multidrug-resistant tuberculosis (MDR-TB) within family households by deletion-targeted multiplex polymerase chain reaction (DTM-PCR), mycobacterial interspersed repetitive unit variable number tandem repeats (MIRU-VNTR) genotyping.
Among 993 MDR-TB patients registered from Wuhan Institute for Tuberculosis Control, drug resistance and the time interval between the index patients and secondary patients were analyzed in 49 MDR-TB patients from 23 families, in which 22 MDR-TB strains from 11 families who had matched strains were genotyped by DTM-PCR and standard 24-loci MIRU-VNTR genotyping method.
The time interval between the index patients and the secondary patients ranged from half a month to 110 months. Thirteen secondary patients developed active MDR-TB within two years and accounted for 50% (13/26) of all secondary patients. Among eleven pairs of MDR-TB families, six pairs had identical genotypes, the cluster rate was 54.5% (12/22); three pairs had a single MIRU-VNTR locus variation. If a single MIRU-VNTR locus variation was tolerated in the cluster definition, the cluster rate raised to 81.8% (18/22).
The family households of MDR-TB patients are at risk for infection of MDR-TB. To reduce transmission, MDR-TB patients should be diagnosed earlier and promptly treated in an effective manner, meanwhile, the close family contacts should be screened for TB infection.
耐药结核病（TB）仍然是一个公共卫生威胁。在中国，关于耐多药结核病（MDR-TB）家庭传播和基因分型的研究很少。本研究旨在通过缺失靶向多重聚合酶链反应（DTM-PCR）和分枝杆菌插入重复单元可变数串联重复（MIRU-VNTR）基因分型来调查家庭内耐多药结核病（MDR-TB）的传播。
在武汉结核病防治所登记的 993 例耐多药结核病患者中，分析了 49 例来自 23 个家庭的耐多药结核病患者的药物耐药性和与二级患者的时间间隔，其中 11 个家庭的 22 株耐多药结核菌株具有匹配的菌株，采用 DTM-PCR 和标准的 24 位 MIRU-VNTR 基因分型方法进行基因分型。
索引患者和二级患者之间的时间间隔从半个月到 110 个月不等。13 名二级患者在两年内发展为活动性 MDR-TB，占所有二级患者的 50%（13/26）。在 11 对 MDR-TB 家庭中，6 对具有相同的基因型，聚类率为 54.5%（12/22）；3 对具有单个 MIRU-VNTR 位点变异。如果在聚类定义中允许单个 MIRU-VNTR 位点变异，则聚类率提高到 81.8%（18/22）。
耐多药结核病患者的家庭存在感染耐多药结核病的风险。为了减少传播，应尽早诊断耐多药结核病患者，并进行有效治疗，同时应对密切家庭接触者进行结核病感染筛查。
