2018—2020年四川省自贡市耐药结核分枝杆菌分子流行病学分析  

Molecular epidemiological analyses of drug-resistant Mycobacterium tuberculosis in Zigong City,2018-2020

作　　者：唐静 王斌[2] 龙莹 汪川 罗睿心 邓建平[2] TANG Jing;WANG Bin;LONG Ying;WANG Chuan;LUO Rui-xin;DENG Jian-ping(West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院(华西第四医院),四川成都610041 [2]自贡市疾病预防控制中心

出　　处：《现代预防医学》2024年第8期1493-1498,共6页Modern Preventive Medicine

基　　金：成都市科技局重大应用示范项目(2022-YF09-00011-SN)。

摘　　要：目的 探究2018—2020年自贡市耐药结核分枝杆菌的聚类情况,分析菌株之间的亲缘关系,推测不同病人中分离的耐药菌株之间是否存在潜在的相关性,为自贡市耐药结核病的防治提供参考依据。方法 以2018—2020年自贡市结核病定点医院分离得到的120株耐药结核分枝杆菌菌株为研究对象,采用标准MIRU-VNTR 12位点法进行分型研究。用PCR和琼脂糖凝胶电泳对扩增产物的条带大小进行分析,获得菌株不同位点的重复次数;将数据导入到MIRU-VNTRplus数据库和SITVIT2网站,构建系统发育树图和最小生成树,并对分离得到的菌株进行全球来源分析;通过位点多态性分析,评价12位点法的分辨能力;通过计算成簇率和近期传播率,分析当地耐药结核病的流行和传播情况。结果 MIRU-VNTR标准12位点分型的总体分辨力HGI指数为0.974,MIRU26和MIRU31呈现高多态性,MIRU10、MIRU16、MIRU39和MIRU40呈现中等多态性,其余位点呈现低多态性。重复次数最集中的位点是MIRU2,最为分散的位点是MIRU26。120株耐药菌株包含77个基因型,成簇率为46.67%,近期传播率为34.17%。最小生成树显示120株耐药菌株根据VNTR分型结果可以分成三个克隆复合体CC1、CC2和CC3。120份菌株中有32株菌的12个基因型可以在SITVIT2网站中找到相应的12MIT编号,12个基因型分布于全球五个洲14个国家。结论 标准VNTR-12位点法对于耐药结核菌株有较好的分辨力,自贡市的耐药结核病存在一定的传播范围,近期传播率较高,针对性的监测有助于结核病的防治。Objective To explore the clustering of drug-resistant Mycobacterium tuberculosis(MTB)in Zigong from 2018 to 2020,analyze the genetic relationship between strains,and speculate whether there is a potential correlation between drug-resistant strains isolated from different patients,so as to provide a reference for the prevention and treatment of drug-resistant tuberculosis in Zigong.Methods The drug-resistant MTB strains isolated from Zigong from 2018 to 2020 were used as the research objects and the standard MIRU-VNTR 12-loci method was used for typing study.The band sizes of the amplified products were analyzed by PCR and agarose gel electrophoresis to obtain the number of replicates of different loci of the strains.The data were imported into the MIRU-VNTRplus database and the SITVIT2 website to construct the phylogenetic tree diagrams and the minimum spanning trees,and the global source analysis of the isolated strains was performed.The discriminatory ability of the 12-locus method was evaluated by locus polymorphism analysis,and the local prevalence and transmission of drug-resistant TB were analyzed by calculating the cluster formation rate and recent transmission rate.Results The overall resolution HGI index of MIRU-VNTR standard 12-loci typing was 0.974.MIRU26 and MIRU31 showed high polymorphism;MIRU10,MIRU16,MIRU39,and MIRU40 showed moderate polymorphism,and the remaining loci showed low polymorphism.The most concentrated locus was MIRU2,and the most dispersed locus was MIRU26.The 120 drug-resistant strains contained 77 genotypes,with a clustering rate of 46.67%and a recent transmission rate of 34.17%.The minimum spanning tree showed that 120 drug-resistant strains could be divided into three clonal complexes,CC1,CC2,and CC3,according to the VNTR typing results.Among the 120 valid strains,12 genotypes of 32 strains could be found on the SITVIT2 website,and the corresponding 12 MIT numbers were distributed in 14 countries on five continents worldwide.Conclusion The standard VNTR-12 locus method resolves dru

关 键 词：自贡市 耐药结核分枝杆菌 分子流行病学 

分 类 号：R521[医药卫生—内科学]