Cao Xiaolong, Li Xinyue, Song Zexuan, He Ping, Zhang Ruiqing, Teng Chong, Sun Qian, Wang Xue, Zhao Bing, Zhang Zhiguo, Zhao Yanlin
National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China.
Outpatient Department, Beijing Changping Institute for Tuberculosis Prevention and Treatment, Beijing, 102200, People's Republic of China.
Infect Drug Resist. 2025 Jan 27;18:499-509. doi: 10.2147/IDR.S503797. eCollection 2025.
College students are a crucial link in curbing the epidemic. The aim of this study is to analyze the genetic diversity and drug resistance of strains in college students with tuberculosis in Beijing, revealing the lineage structure and transmission patterns specific to this group.
This study used the hospital's electronic management system to screen for tuberculosis among college students in Changping District, Beijing, from January 2004 to December 2023. Socio-demographic and clinical data were collected, and whole-genome sequencing was performed on culture-positive isolates. Isolates with a genetic distance of less than 12 SNPs were grouped into the same genomic cluster. The TB Profiler software predicted drug resistance mutations, and categorical data were analyzed using Chi-square or Fisher's exact tests.
Among the 1436 college students with tuberculosis, a total of 153 isolates successfully underwent whole-genome sequencing. The results showed that about one-third (49/153) of the isolates carried one or more drug resistance genes, with more than half (26/49) associated with first-line anti-tuberculosis drugs. However, encouragingly, the incidence of drug-resistant tuberculosis showed a significant downward trend, with statistical significance (<0.05). Lineage 2 (86.3%, 132/153) was the predominant genotype, with the Beijing genotype (90.1%, 120/153) being the most common, while the isolation of Lineage 3 in a student from Xinjiang. Sixteen college student isolates clustered, and all of which were Beijing genotype. Transmission within the same campus showed characteristics of short clustering time.
The drug resistance rate among college students is relatively high, however it shows a declining trend. School tuberculosis infections could stem not only from within-campus transmission but also necessitate consideration of spatial and cross-regional spread possibilities.
大学生是遏制疫情的关键环节。本研究旨在分析北京大学生结核病患者菌株的遗传多样性和耐药性，揭示该群体特有的谱系结构和传播模式。
本研究利用医院电子管理系统，对2004年1月至2023年12月间北京市昌平区大学生中的结核病患者进行筛查。收集社会人口学和临床数据，并对培养阳性的分离株进行全基因组测序。遗传距离小于12个单核苷酸多态性（SNP）的分离株被归为同一基因组簇。使用TB Profiler软件预测耐药突变，分类数据采用卡方检验或Fisher精确检验进行分析。
在1436例大学生结核病患者中，共有153株分离株成功进行了全基因组测序。结果显示，约三分之一（49/153）的分离株携带一种或多种耐药基因，其中一半以上（26/49）与一线抗结核药物相关。然而，令人鼓舞的是，耐多药结核病的发病率呈显著下降趋势，具有统计学意义（<0.05）。2型谱系（86.3%，132/153）是主要基因型，北京基因型（90.1%，120/153）最为常见，同时在一名来自新疆的学生中分离出3型谱系。16株大学生分离株聚类，均为北京基因型。同一校园内的传播显示出聚类时间短的特点。
大学生中的耐药率相对较高，但呈下降趋势。学校结核病感染不仅可能源于校内传播，还需要考虑空间和跨区域传播的可能性。
