Spoligotyping方法对青海省黄南州两所学校结核病疫情的溯源研究

Study on infectious source resulting tuberculosis outbreak in two schools of Huangnan prefecture in Qinghai province by spoligotyping

目的明确青海省黄南州学校结核病疫情的传染源。方法采用PPD试验方法、胸部X线检查、痰涂片和痰培养检查等对19例患者做出诊断,并推测疫情流行情况;采用间隔区寡核苷酸分型(Spoligotyping)方法对分离的5株菌株进行分析,确定传染源。结果对两校1 357名学生进行PPD检测,阳性率54.97%(746/1 357),强阳性率27.27%(370/1 357)。两校1 529名学生中,诊断结核病患者19例,结核患病率1.24%(19/1 529);分离结核菌株5株,Spoligotyping方法均确定为典型北京基因型,采用Bio Numerics软件进行聚类分析,5株结核菌均归为一簇。结论黄南州两所学校结核病的流行可以认为是同源暴发,病原体为典型北京基因型结核杆菌,传染源为甲学校一结核病男生。

Objective To identify the infection source of tuberculosis outbreak happened in two schools of Huangnan prefecture. Methods PPD test,chest X-ray,sputum smear and culture were used to investigate the tuberculosis epidemic and found 19 patients with tuberculosis and 5 isolated of tuberculosis were analyzed by Spoligotyping to determine the source of infection. Results 1 357 students were tested by PPD,found positive rate was 54. 97%（ 746 /1 357） and strong positive rate was 27. 27%（ 370 /1 357）. Among 1 529 school students,18 patients with tuberculosis were found and prevalence rate was 1. 24%（ 19 /1 529）. 5strains of tuberculosis were isolated and were identified as typical Beijing genotype by Spoligotyping and were classified as a same cluster by Bio Numerics software. Conclusions Outbreak of tuberculosis in two schools of Huangnan prefecture comes from the same source,who was a boy patient with tuberculosis. Pathogen of Mycobacterium tuberculosis is typical Beijing genotype.