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耐多药结核病——两例北京基因型结核病例的诊断程序与治疗

Multidrug-Resistant Tuberculosis-Diagnostic Procedures and Treatment of Two Beijing-like TB Cases.

作者信息

Kozińska Monika, Skowroński Marcin, Gruszczyński Paweł, Augustynowicz-Kopeć Ewa

机构信息

Department of Microbiology, National Tuberculosis and Lung Diseases Research Institute, Plocka 26, 01-138 Warsaw, Poland.

Wielkopolska Pulmonology and Thoracic Surgery Centre of Eugenia and Janusz Zeyland, Szamarzewskiego 62, 60-569 Poznań, Poland.

出版信息

Diagnostics (Basel). 2022 Jul 12;12(7):1699. doi: 10.3390/diagnostics12071699.

Abstract

The Beijing/W genotype is one of the major molecular families of complex (MTBC), responsible for approximately 50% of tuberculosis (TB) cases in Far East Asia and at least 25% of TB cases globally. Studies have revealed that the Beijing genotype family is associated with a more severe clinical course of TB, increased ability to spread compared to other genotypes, and an unpredictable response to treatment. Based on the profile of spacers 35-43 in the Direct Repeat (DR) locus of the MTBC genome determined by spoligotyping, classical (typical) and modern (Beijing-like) clones can be identified within the Beijing family. While the modern and ancient Beijing strains appear to be closely related at the genetic level, there are marked differences in their drug resistance, as well as their ability to spread and cause disease. This paper presents two cases of drug-resistant tuberculosis caused by rare mycobacteria from the Beijing family: the Beijing 265 and Beijing 541 subtypes. The genotypes of isolated strains were linked with the clinical course of TB, and an attempt was made to initially assess whether the Beijing subtype can determine treatment outcomes in patients.

摘要

北京/W基因型是结核分枝杆菌复合群(MTBC)的主要分子家族之一,在东亚地区约占结核病(TB)病例的50%,在全球至少占TB病例的25%。研究表明,北京基因型家族与更严重的TB临床病程、比其他基因型更强的传播能力以及对治疗不可预测的反应相关。根据通过间隔寡核苷酸分型法确定的MTBC基因组直接重复序列(DR)位点中35-43位间隔序列的特征,可以在北京家族中识别出经典(典型)和现代(类北京)克隆。虽然现代和古代北京菌株在基因水平上似乎密切相关,但它们在耐药性、传播能力和致病能力方面存在显著差异。本文介绍了两例由北京家族罕见分枝杆菌引起的耐药结核病病例:北京265和北京541亚型。分离菌株的基因型与TB临床病程相关,并尝试初步评估北京亚型是否能决定患者的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbb6/9318939/55c6d5101711/diagnostics-12-01699-g001.jpg

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