结核分枝杆菌间隔区寡核苷酸分型法分析

Spoligotyping of clinic isolates of Mycobacterium tuberculosis

目的应用间隔区寡核苷酸分型(spoligotyping)方法分析甘肃省结核分枝杆菌临床分离株的分子型别特征。方法用spoligotyping基因分型方法,对甘肃省兰州市肺科医院住院或门诊确诊患者分离的结核分枝杆菌进行分型,采用BioNumerics 4.5软件进行聚类(cluster)分析,对聚类结果与国际间隔寡核苷酸分型数据库(SpolDB4)对比。结果 215株临床分离株被分成3个基因群22种基因型,其中成簇菌株形成11个基因型共204株,独特基因型菌株11株;北京家庭基因型结核分枝杆菌占86.51%(186/215),T4占4.19%(9/215)、H1占1.86%(4/215)、MANU占1.40%(3/215)等基因型;Logistic多元回归分析结果表明,北京家庭基因型与患者性别、年龄、职业、抗结核治疗史、耐药、发病情况和菌种耐药性、来源地等均无关联。结论甘肃省结核分枝杆菌临床分离株基因具有多态性,北京家族基因型结核分枝杆菌为该地区主要流行株,其他罕见的基因型结核分枝杆菌也值得重视。

Objective To explore molecular chracteristics and distribution of Mycobacterium tuberculosis（M.tuberculosis） in Lanzhou area,Gansu province with traditional 43-space spoligotyping.Methods Totally 215 M.tuberculosis strains were ioslated from confirmed patients in Lanzhou Pulmonary Disease Hospital and were genotyped by traditional 43-space spoligotyping.The characteristics of DNA fingerprinting of the strains was analyzed with BioNumerics 4.5 software.The results were compaed with International Spoligotyping Datebase（SpolDB4）.Results Of all the strains,86.98%（204/215） were grouped into 11 clusters（spoligotypes） with other 11 unique strains.Among 22 spoligotypes（STs）,12 spoligotypes were cluster strains,while 10 spoligotypes（14 strains） were new and unique（orphan）.Beijing family genotype was the most common genotype family（86.51%）,followed by T family（4.19%）,H family（1.86%）,and MANU family（1.40%）.Multivariate logistic regression analyses showed no statistically significant association between the Beijing family genotype strains and resistance to all of four drugs（rifampicin,isonizid,ethambutol,and streptomycin）,patient＇s gender,age,job,residence of the patients,antituberculosis therapy history,regular or irregular therapy,and new cases or relapse cases.Conclusion The strains of M.tuberculosis isolated in Gansu province present definite gene diversity.Beijing family genotype is the most epidemic genotype in the region and other genotypes of M.tuberculosis should be emphasized to prevent and control the spread of other spoligotypes strains.