2020年南充市一中学结核病疫情临床分离菌株情况分析  

Analysis of clinical isolates of tuberculosis outbreak from a middle school in Nanchong City 2020

作　　者：张书[1] 陈闯[1] 逯嘉[1] 肖月[1] 卿敏 甘赟婧 陈真 罗湘 周扬[5] ZHANG Shu;CHEN Chuang;LU Jia;XIAO Yue;QING Min;GAN Yunjing;CHEN Zhen;LUO Xiang;ZHOU Yang(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China.;Nanchong Center for Disease Control and Prevention,Nanchong 637000,Sichuan Province,China.;Jialing District Center for Disease Control and Prevention,Nanchong 637000,Sichuan Province,China.;Guangan District Center for Disease Control and Prevention,Guangan 638500,Sichuan Province,China.;China Center for Disease Control and Prevention,Beijing 102206,China.)

机构地区：[1]四川省疾病预防控制中心,成都610041 [2]南充市疾病预防控制中心,四川南充637000 [3]南充市嘉陵区疾病预防控制中心,四川南充637000 [4]广安市广安区疾病预防控制中心,四川广安638500 [5]中国疾病预防控制中心,北京102206

出　　处：《预防医学情报杂志》2023年第11期1332-1336,共5页Journal of Preventive Medicine Information

摘　　要：目的通过对一中学校结核病疫情中得到的临床分离菌株进行全基因组测序和分析,确定其耐药、分型特征及传播特点,探讨全基因组测序技术在学校结核病疫情处置中的应用价值。方法对2020年南充市一中学结核病疫情中得到的17株菌株进行全基因组测序,并使用结核分枝杆菌全基因组数据库分析平台SAM-TB对其菌型、耐药、分型特征进行分析,并结合患者信息分析其传播特点。结果该学校结核病疫情得到的17株临床菌株,13株为结核分枝杆菌(Mycobacterium Tuberculosis,MTB),2株为脓肿分枝杆菌(Mycobacteroides abscessus),2株为支气管戈登氏菌(Gordonia bronchialis),13株MTB中12株属于L2.2.1,1株属于L4.5。L2.2.1谱系的12株菌株中10株为同一株菌,且来自于发生聚集性疫情的班级,由此确定该次疫情由此株菌传播引起。结论该次学校结核病疫情是由谱系为L2.2.1的结核分枝杆菌引起的聚集性传播事件,全基因组测序技术在学校结核病疫情处置中具有确定传播链的重要作用。Objective Whole-genome sequencing and analysis was performed on a clinical isolated strain from tuberculosis outbreak in a middle school,to determine their drug resistance,typing characteristics and transmission characteristics,and to explore the application value of whole-genome sequencing technology in the management of school tuberculosis outbreaks.Methods Whole genome sequencing was performed on 17 TB strains from the middle school in Nanchong City in 2020,Mycobacterial type,drug resistance and typing characteristics of strains were analyzed by using SAM-TB(a whole-genome database analysis platform for Mycobacterium tuberculosis),and their transmission characteristics were analyzed combined with patient information.Results About 13 strains of the 17 clinical strains obtained from this school TB outbreak were Mycobacterium Tuberculosis(MTB),2 were Mycobacteroides abscessus,2 were Gordonia bronchialis.12 strains of the 13 MTB strains belonged to L2.2.1,and 1 belonged to L4.5.And 10 of the 12 strains of the L2.2.1 spectrum were the same strain and came from the class where the outbreak occurred,thus the outbreak was determined to be caused by the transmission of this strain.Conclusions The school tuberculosis outbreak was an aggregated transmission event caused by MTB of spectrum L2.2.1,and whole-genome sequencing technology has an important role in identifying the transmission chain in the management of school tuberculosis outbreaks.

关 键 词：结核病 学校 结核分枝杆菌 全基因组测序 进化树 

分 类 号：R52[医药卫生—内科学] R446.5[医药卫生—临床医学]