摘要
目的:基于基因分型了解北京市结核病患者复发原因及菌株遗传特征,为复发结核病患者的有效防治提供科学依据。方法:采用RD105基因缺失法和15位点可变数目串联重复序列基因分型实验(MIRU-VNTR),比较2017年1月至2019年12月期间北京市复发结核病患者前后两次发病时结核分枝杆菌基因型有无差异,判断结核病患者复发原因。以复发结核病患者末次菌株为研究对象,评价该基因分型技术对北京地区复发患者结核分枝杆菌的分辨能力,从系统发育学角度对流行于复发患者中的结核分枝杆菌进行研究,探讨北京市复发患者菌株的遗传特征。结果:复发结核病患者内源性复燃比例为65.4%(51/78),外源性再感染比例为34.6%(27/78)。复发患者末次分离的78株结核分枝杆菌菌株中,71株为北京基因型,7株为非北京基因型。78株结核分枝杆菌呈现68种基因型,2个克隆复合群中,13例患者菌株成4个簇,24例患者独特性菌株中,2株菌株成1个簇,成簇率为12.8%。15个VNTR位点对所有结核分枝杆菌菌株的分辨率指数值为0.994。结论:北京市结核病患者复发的主要原因是内源性复燃,菌株成簇率较低,主要流行菌株为北京基因型,呈现出较高的遗传多样性。
Objective:To investigate the causes of recurrence in tuberculosis patients in Beijing and the genetic characteristics of their strains,aiming to provide a scientific basis for the effective prevention and treatment of recurrent tuberculosis patients.Methods:The RD105 gene deletion method and 15-locus variable number tandem repeat genotyping experiment(VNTR)were used to compare the genotypes of Mycobacterium tuberculosis(MTB)of the initial and recurrent episodes in pulmonary tuberculosis patients in Beijing from January 2017 to December 2019,to elucidate the etiology of recurrent tuberculosis.The final isolates from recurrent patients were selected to evaluate the discriminatory ability of the genotyping technology on MTB strains of Beijing.Furthermore,a phylogenetic analysis was conducted to investigate the genetic characteristics of MTB prevalent in recurrent patients,providing insights into the evolutionary relationships within the strains associated with recurrent tuberculosis cases in Beijing.Results:The proportion of endogenous reactivation among recurrent patients was 65.4%(51/78),while the proportion of exogenous reinfection was 34.6%(27/78).Among the 78 MTB isolates obtained from recurrent patients,71 were Beijing genotype,and 7 were non-Beijing genotype.78 strains exhibited 68 distinct genotypes.Within 2 clonal complex clusters,13 isolates formed 4 clusters,while among 24 unique strains,2 isolates formed 1 cluster,resulting in a clustering rate of 12.8%.The hunter-gaston discrimination index for all MTB strains across the 15 VNTR loci was 0.994.Conclusion:The primary cause of recurrent tuberculosis in Beijing was endogenous reactivation,with a relatively low clustering rate.The predominant strain was Beijing genotype,exhibiting a high degree of genetic diversity.
作者
张洁
丁北川
任怡宣
田丽丽
易俊莉
庞梦迪
杨新宇
Zhang Jie;Ding Beichuan;Ren Yixuan;Tian Lili;Yi Junli;Pang Mengdi;Yang Xinyu(Tuberculosis Laboratory,Beijing Center for Disease Prevention and Control,Beijing 100035,China)
出处
《结核与肺部疾病杂志》
2024年第2期128-134,共7页
Journal of Tuberculosis and Lung Disease
基金
首都卫生发展科研专项(2024-2G-30114)
北京市疾病预防控制中心科研培育专项(2023-KYJH-05,2023-KYJH-07)。
关键词
复发
分枝杆菌
结核
基因型
Recurrence
Mycobacterium tuberculosis
Genotype