Genetic Diversity of Mycobacterium tuberculosis Isolates from a Tertiary Care Tuberculosis Hospital in South Korea
Genetic Diversity of Mycobacterium tuberculosis Isolates from a Tertiary Care Tuberculosis Hospital in South Korea
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DOI：
10.1128/jcm.02167-09
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发表时间：
2010-02-01
影响因子：
9.4
通讯作者：
Barry, Clifton E., III
中科院分区：
文献类型：
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作者：
Shamputa, Isdore Chola;Lee, Jongseok;Barry, Clifton E., III
在大韩民国，结核病仍然是一个巨大的公共卫生问题，尽管在过去30年中该疾病的流行率下降了五倍多。耐药结核病的增加使情况更加复杂。我们分析了208株临床分离的M。通过spoligotyping、IS 6110限制性片段长度多态性（RFLP）和基于24个位点的分枝杆菌散布重复单位-可变数目串联重复序列（MIRU-VNTR）分型，对来自国立马山结核病医院的结核病患者进行分析，以评估韩国结核杆菌的多样性和传播动力学。绝大多数菌株（97.1%）属于北京基因型。MIRU-VNTR聚类分析得到的聚类率较低，为22.3%，大部分聚类由具有不同耐药模式的分离株组成。RFLP和MIRU-VNTR分型方法的区分能力高（等位基因多样性[h] = 0.99），但spoligotyping低（h = 0.31）。虽然需要对19个MIRU-VNTR基因座进行分析以实现最大区分，但鉴定了能够区分大多数密切相关菌株的8个基因座（960、1955、2163 b、2165、2996、3192、4052和4348）（h = 0.98）的信息组。这些结果表明，基于24个位点的MIRU-VNTR分型可能是RFLP的一种合适的替代方法，以区分这种情况下的临床分离株，这是占主导地位的M。结核病北京株。在研究范围内，我们的结果还表明，大韩民国耐药结核病的问题可能主要是由于获得性耐药性而不是传播。
Tuberculosis (TB) remains an immense public health problem in the Republic of Korea despite a more than fivefold decrease in the prevalence of the disease over the last 3 decades. The rise in drug-resistant TB has compounded the situation. We analyzed 208 clinical isolates of M. tuberculosis from the National Masan Tuberculosis Hospital by spoligotyping, IS6110 restriction fragment length polymorphism (RFLP), and 24-locus-based mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing to assess the diversity and transmission dynamics of the tubercle bacilli in the Republic of Korea. The majority of the isolates (97.1%) belonged to the Beijing genotype. Cluster analysis by MIRU-VNTR yielded a low clustering rate of 22.3%, with most of the clusters comprising isolates with diverse drug resistance patterns. The discriminatory capacity of the typing methods was high for RFLP and MIRU-VNTR (allelic diversity [h] = 0.99) but low for spoligotyping (h = 0.31). Although analysis of 19 MIRU-VNTR loci was needed to achieve maximum discrimination, an informative set of 8 loci (960, 1955, 2163b, 2165, 2996, 3192, 4052, and 4348) (h = 0.98) that was able to differentiate most of the closely related strains was identified. These findings suggest that 24-locus-based MIRU-VNTR typing is a likely suitable alternative to RFLP to differentiate clinical isolates in this setting, which is dominated by M. tuberculosis Beijing strains. Within the study limits, our results also suggest that the problem of drug-resistant TB in the Republic of Korea may be largely due to acquired resistance as opposed to transmission.