Laboratory of Molecular Epidemiology and Evolutionary Genetics, St. Petersburg Pasteur Institute, St. Petersburg, Russia.
Novosibirsk Tuberculosis Research Institute, Novosibirsk, Russia.
Infect Genet Evol. 2022 Sep;103:105343. doi: 10.1016/j.meegid.2022.105343. Epub 2022 Jul 24.
The dramatic change in global health imposed by the Covid-19 pandemic has also impacted TB control. The TB incidence decreased dramatically not because of the improved situation but due to undertesting, reduced resources, and ultimately, substantially reduced detection rate. We hypothesized that multiple and partly counteracting factors could influence changes in the local Mycobacterium tuberculosis population. To test this hypothesis, we analyzed M. tuberculosis isolates collected in Western Siberia, Russia, before and during the Covid-19 pandemic. A total of 269 M. tuberculosis isolates from patients admitted at referral clinics were studied. The pre-pandemic and pandemic collections included 179 and 90 isolates, respectively. Based on genotyping, both pre-pandemic and pandemic samples are heavily dominated by the Beijing genotype isolates (95% and 88%) that were mostly MDR (80 and 68%). The high proportion of MDR isolates is due to the specific features of the studied collections biased towards patients with severe TB admitted at the National referral center in Novosibirsk. While no dramatic change was observed in the M. tuberculosis population structure in the survey area in Western Siberia during the Covid-19 pandemic in 2020-2021 compared to the pre-pandemic collection, still we note a certain decrease of the Beijing genotype and an increase in the proportion and diversity of the non-Beijing isolates. However, the transmissible and MDR Beijing B0/W148 did not increase its prevalence rate during the pandemic. More generally, the high prevalence rate of the Beijing genotype and its strong association with MDR both before and during the pandemic are alarming features of this region in Western Siberia, Russia.
Covid-19 大流行给全球卫生带来的戏剧性变化也影响了结核病控制。结核病发病率的急剧下降不是因为情况的改善，而是因为检测不足、资源减少，最终导致检测率大幅下降。我们假设，多种部分相互抵消的因素可能会影响当地结核分枝杆菌群体的变化。为了验证这一假设，我们分析了俄罗斯西西伯利亚在新冠疫情前后收集的结核分枝杆菌分离株。总共研究了来自转诊诊所住院患者的 269 株结核分枝杆菌分离株。大流行前和大流行期间的样本分别包含 179 株和 90 株。基于基因分型，大流行前和大流行期间的样本均主要由北京基因型分离株主导（分别占 95%和 88%），这些分离株大多为耐多药（分别占 80%和 68%）。高比例的耐多药分离株是由于研究样本的特定特征偏向于在新西伯利亚国家转诊中心住院的严重结核病患者。虽然与大流行前样本相比，2020-2021 年新冠疫情期间西西伯利亚调查地区的结核分枝杆菌种群结构没有发生明显变化，但我们仍注意到北京基因型的比例略有下降，而非北京基因型的比例和多样性有所增加。然而，传播性和耐多药的北京 B0/W148 基因型在大流行期间并未增加其流行率。更普遍地说，北京基因型的高流行率及其在大流行前后与耐多药的强关联是俄罗斯西西伯利亚该地区令人担忧的特征。
