云南省结核分枝杆菌分子特征和传播相关因素分析  

Analysis of Molecular Characteristics of MycobacteriumTuberculosis and Factors Associated with Transmission inYunnan Province

作　　者：陈连勇[1] 杨星[1] 茹浩浩 陈涛 闫双群[1] 许琳[1] CHEN Lianyong;YANG Xing;RU Haohao;CHEN Tao;YAN Shuangqun;XU Lin(Institute for Tuberculosis Control and Prevention,Yunnan Center for Disease Control and Prevention,Kunming Yunnan 650022,China)

机构地区：[1]云南省疾病预防控制中心结核病防治所,云南昆明650022

出　　处：《昆明医科大学学报》2023年第8期1-7,共7页Journal of Kunming Medical University

基　　金：国家自然科学基金资助项目(81560544)。

摘　　要：目的 了解云南省结核分枝杆菌基因型分布特征、传播及其相关影响因素,为结核病控制提供政策依据。方法 收集云南省32耐药监测县(区)于2016年至2019年分离的分枝杆菌菌株,采用Spoligotyping和15个MIRU-VNTR位点技术对结核分枝杆菌进行基因分型。结果 共收集到846株结核分枝杆菌,539株为北京基因型(63.71%),307株非北京基因型包括T1(20.69%,175/846)、T3(4.49%,38/846)、T2(2.36%,20/846)等共16个基因型以及42株(4.96%)新发现或未定义菌株。846株结核分枝杆菌的成簇率为25.89%,其中北京基因型的成簇率为29.68%,非北京基因型成簇率为19.22%,两者差异有统计学意义(χ2=15.14,P <0.001);北京基因型和非北京基因型结核分枝杆菌与耐药无关;Logistic回归分析显示北京基因型成簇风险是非北京基因型的1.861倍(P <0.05,95%CI 1.376~2.516),而INH敏感菌株是耐药菌株的1.869倍(P <0.05,95%CI 1.129~3.094)。结论 云南省结核分枝杆菌基因型呈高度多态性,但北京基因型仍是主要流行株,云南省存在结核病的近期传播,北京基因型和INH敏感是近期传播的影响因素。Objective To understand the distribution characteristics,transmission,and related influencing factors of Mycobacterium tuberculosis genotypes in Yunnan Province,and to provide policy basis for tuberculosis control.Methods Mycobacterium tuberculosis strains isolated from 32 drug-resistant monitoring counties districts in Yunnan Province from 2016 to 2019 were collected,and Spoligotyping and 15 MIRU-VNTR loci were used for genetic typing of Mycobacterium tuberculosis.Results A total of 846 Mycobacterium tuberculosis strains were collected,of which 539 strains were Beijing genotype(63.71%),307 strains were non-Beijing genotype,including 16 genotypes such as T1(20.69%,175/846),T3(4.49%,38/846),T2(2.36%,20/846),and 42 strains(4.96%)were newly discovered or undefined strains.The clustering rate of 846 Mycobacterium tuberculosis strains was 25.89%,of which the clustering rate of Beijing genotype was 29.68%,and the clustering rate of non-Beijing genotype was 19.22%.There was a significant difference between the two(χ2=15.14,P<0.001).Beijing genotype and non-Beijing genotype Mycobacterium tuberculosis were not related to drug resistance.Logistic regression analysis showed that the clustering risk of Beijing genotype was 1.861 times that of non-Beijing genotype(P<0.05,95%CI 1.376-2.516),and the risk of INH-sensitive strains was 1.869 times that of drug-resistant strains(P<0.05,95%CI1.129-3.094).Conclusion The Mycobacterium tuberculosis genotypes in Yunnan province are highly polymorphic,but the Beijing genotype is still the main epidemic strain.There is recent prevalence of tuberculosis in Yunnan Province,and Beijing genotype and INH sensitivity are influencing factors for recent transmission.

关 键 词：结核病 结核分枝杆菌 基因型 分子流行病学 近期传播 

分 类 号：R521[医药卫生—内科学] R378.911[医药卫生—临床医学]