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基于全基因组序列对乌鲁木齐市耐药菌耐药特征、遗传多样性及传播动力学的分析

Whole Genome Sequence-Based Analyses of Drug Resistance Characteristics, Genetic Diversity, and Transmission Dynamics of Drug-Resistant in Urumqi City.

作者信息

Yang Jiandong, Lu Yaoqin, Chen Yanggui, Wang Yida, Wang Kai

机构信息

School of Public Health, Xinjiang Medical University, Urumqi, 830017, People's Republic of China.

Department of Tuberculosis Control and Prevention, Urumqi Center for Disease Control and Prevention, Urumqi, 830026, People's Republic of China.

出版信息

Infect Drug Resist. 2024 Mar 23;17:1161-1169. doi: 10.2147/IDR.S454913. eCollection 2024.

DOI:10.2147/IDR.S454913
PMID:38544963
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10967994/
Abstract

OBJECTIVE

This study aims to analyze the drug resistance spectrum, genetic diversity, and transmission dynamics to provide a basis for the prevention and control of drug-resistant (DR) tuberculosis (TB) epidemics.

METHODS

This retrospective study is based on routine national drug resistance surveillance. The demographic, epidemiological, and clinical information on DR-TB patients from 2016 to 2021 was collected and used for phenotypic drug susceptibility testing and whole-genome sequencing.

RESULTS

It was indicated that L2.2.1 was the dominant lineage in Urumqi. The drug resistance spectrum in Urumqi was narrow, which means more drug combinations can be used for clinical treatment. Furthermore, mutations identification of drug-resistance gene and are important for clinical drug use. However, mutations in cross-resistance genes have limited guidance for clinical selection of KM, CPM and AK. Moreover, there is an increased risk of cluster transmission of DR-TB, and the difference in clustering rate among L2, L3, and L4 was not statistically significant ( = 2.6410, = 0.2670).

CONCLUSION

In the Urumqi, DR-TB has a complex prevalence state, a narrow drug resistance spectrum, and a high clustering rate and burden of drug resistance. To reduce the burden of DR-TB, related research should be strengthened, and the development of prevention, control, and treatment strategies should be accelerated.

摘要

目的

本研究旨在分析耐药谱、遗传多样性和传播动态,为耐药结核病(TB)流行的预防和控制提供依据。

方法

本回顾性研究基于全国常规耐药监测。收集了2016年至2021年耐药结核病患者的人口统计学、流行病学和临床信息,并用于表型药物敏感性试验和全基因组测序。

结果

结果表明,L2.2.1是乌鲁木齐的主要谱系。乌鲁木齐的耐药谱较窄,这意味着更多的药物组合可用于临床治疗。此外,耐药基因和的突变鉴定对临床用药很重要。然而,交叉耐药基因的突变对卡那霉素(KM)、卷曲霉素(CPM)和阿米卡星(AK)的临床选择指导有限。此外,耐药结核病存在聚集性传播风险增加的情况,L2、L3和L4之间的聚集率差异无统计学意义(=2.6410,=0.2670)。

结论

在乌鲁木齐,耐药结核病呈现复杂的流行状态,耐药谱较窄,聚集率和耐药负担较高。为减轻耐药结核病负担,应加强相关研究,加快预防、控制和治疗策略的制定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca37/10967994/b5816ad4b5ed/IDR-17-1161-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca37/10967994/f6dabe03f2ab/IDR-17-1161-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca37/10967994/b3b2e609bdca/IDR-17-1161-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca37/10967994/b5816ad4b5ed/IDR-17-1161-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca37/10967994/f6dabe03f2ab/IDR-17-1161-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca37/10967994/b3b2e609bdca/IDR-17-1161-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca37/10967994/b5816ad4b5ed/IDR-17-1161-g0003.jpg

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