Lin Shufang, Wei Shuzhen, Zhao Yong, Dai Zhisong, Lin Jian, Pang Yu
Fujian Provincial Key Laboratory of Zoonosis Research, Fujian Center for Disease Control and Prevention, Fuzhou, People's Republic of China.
Department of Bacteriology and Immunology, Beijing Key Laboratory for Drug-Resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, People's Republic of China.
Infect Drug Resist. 2022 Oct 1;15:5781-5793. doi: 10.2147/IDR.S380950. eCollection 2022.
Here, we aimed to determine the population structure of (MTB) genotypes in Fujian and explore risk factors associated with infection with the Beijing genotype. We also explored the association between Beijing genotype and drug resistance.
Representative MTB isolates obtained during provincial-level routine anti-tuberculosis drug resistance surveillance conducted since 2013 in 11 Fujian counties were analyzed using McSpoligotyping. In vitro drug susceptibilities to anti-tuberculosis drugs were determined using the standard Löwenstein-Jensen proportion method.
Overall, 477 MTB isolates were included in the study, of which 245 isolates belonged to the Beijing genotype family and 232 possessed non-Beijing genotypes. Ultimately, a total of 204 spoligotypes were identified that included 58 spoligotype international types (SITs) from the SITVITWEB database and 146 novel spoligotypes. As compared to patients <25 years of age (control group), elderly patients (≥65 years of age) were more likely to be infected with non-Beijing genotypes [aOR 18.69, 95% CI (5.80-60.26)], with risk of infection with non-Beijing genotypes increasing with age [aOR 3.73, 95% CI (1.67-8.30) for patients 45-64 years of age]. Additionally, as compared to isolates with Beijing and other non-Beijing genotypes, significantly greater proportions of isolates with novel spoligotypes exhibited PTO- and PAS-resistance. Moreover, a markedly higher proportion of isolates with novel spoligotypes exhibited OFX-resistance as compared to isolates with other non-Beijing genotypes.
Our data demonstrated that the Beijing genotype is the predominant MTB sublineage in Fujian and that the prevalence rate of infection with this MTB genotype decreases with advancing patient age. Notably, the prevalence rate of this genotype in Fujian TB patients is relatively lower than in other regions of China. In addition, the emergence of novel spoligotypes of highly drug-resistant MTB isolates highlights the urgent need for ongoing molecular genotyping surveillance in Fujian.
在此，我们旨在确定福建结核分枝杆菌（MTB）基因型的群体结构，并探索与北京基因型感染相关的危险因素。我们还探讨了北京基因型与耐药性之间的关联。
对自2013年以来在福建11个县进行的省级常规抗结核药物耐药性监测期间获得的代表性MTB分离株进行了McSpoligotyping分析。使用标准的罗氏培养基比例法测定了对抗结核药物的体外药敏性。
总体而言，本研究共纳入477株MTB分离株，其中245株属于北京基因型家族，232株具有非北京基因型。最终，共鉴定出204种spoligotypes，其中包括来自SITVITWEB数据库的58种spoligotype国际类型（SITs）和146种新的spoligotypes。与<25岁的患者（对照组）相比，老年患者（≥65岁）更易感染非北京基因型[aOR 18.69，95%CI（5.80 - 60.26）]，且非北京基因型感染风险随年龄增加而升高[45 - 64岁患者的aOR 3.73，95%CI（1.67 - 8.30）]。此外，与具有北京和其他非北京基因型的分离株相比，具有新spoligotypes的分离株中对丙硫异烟胺和对氨基水杨酸耐药的比例显著更高。而且，与其他非北京基因型的分离株相比，具有新spoligotypes的分离株中对氧氟沙星耐药的比例明显更高。
我们的数据表明，北京基因型是福建MTB的主要亚系，且该MTB基因型的感染患病率随患者年龄增长而降低。值得注意的是，该基因型在福建结核病患者中的患病率相对低于中国其他地区。此外，高耐药MTB分离株新spoligotypes的出现凸显了福建持续进行分子基因分型监测的迫切需求。
