Department of Tuberculosis Control, Guangzhou Chest Hospital, Guangzhou, China.
Department of Preventive Health Care, Guangzhou Chest Hospital, Guangzhou, China.
Front Public Health. 2023 May 11;11:1156930. doi: 10.3389/fpubh.2023.1156930. eCollection 2023.
China is a country with a high burden of tuberculosis (TB). TB outbreaks are frequent in schools. Thus, understanding the transmission patterns is crucial for controlling TB.
In this genomic epidemiological study, the conventional epidemiological survey data combined with whole-genome sequencing was used to assess the genotypic distribution and transmission characteristics of strains isolated from patients with TB attending schools during 2015 to 2019 in Guangzhou, China.
The TB incidence was mainly concentrated in regular secondary schools and technical and vocational schools. The incidence of drug resistance among the students was 16.30% (22/135). The phylogenetic tree showed that 79.26% (107/135) and 20.74% (28/135) of the strains belonged to lineage 2 (Beijing genotype) and lineage 4 (Euro-American genotype), respectively. Among the 135 isolates, five clusters with genomic distance within 12 single nucleotide polymorphisms were identified; these clusters included 10 strains, accounting for an overall clustering rate of 7.4% (10/135), which showed a much lower transmission index. The distance between the home or school address and the interval time of symptom onset or diagnosis indicated that campus dissemination and community dissemination may be existed both, and community dissemination is the main.
TB cases in Guangzhou schools were mainly disseminated and predominantly originated from community transmission. Accordingly, surveillance needs to be strengthened to stop the spread of TB in schools.
中国是一个结核病（TB）负担沉重的国家。学校经常爆发结核病疫情。因此，了解传播模式对于控制结核病至关重要。
在这项基于基因组的流行病学研究中，结合常规流行病学调查数据和全基因组测序，评估了 2015 年至 2019 年期间在中国广州就读学校的结核病患者分离株的基因型分布和传播特征。
结核病发病率主要集中在正规中学和职业技术学校。学生的耐药率为 16.30%（22/135）。系统进化树显示，79.26%（107/135）和 20.74%（28/135）的菌株分别属于谱系 2（北京基因型）和谱系 4（欧美基因型）。在 135 株分离株中，鉴定出 5 个基因组距离在 12 个单核苷酸多态性以内的聚类；这些聚类包括 10 株，总聚类率为 7.4%（10/135），表明传播指数较低。家庭或学校地址与症状发作或诊断间隔时间之间的距离表明，可能存在校园传播和社区传播，且社区传播是主要传播方式。
广州学校的结核病病例主要是通过社区传播进行传播的，因此需要加强监测，以阻止结核病在学校的传播。
