Drug resistant Mycobacterium tuberculosis of the Beijing genotype does not spread in Sweden.
Drug resistant Mycobacterium tuberculosis of the Beijing genotype does not spread in Sweden.
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北京基因型的耐药结核分枝杆菌并未在瑞典传播。
DOI：
10.1371/journal.pone.0010893
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发表时间：
2010-05-28
期刊：
影响因子：
3.7
通讯作者：
Kallenius, Gunilla
中科院分区：
文献类型：
--
作者：
Ghebremichael, Solomon;Groenheit, Ramona;Pennhag, Alexandra;Koivula, Tuija;Andersson, Emmi;Bruchfeld, Judith;Hoffner, Sven;Romanus, Victoria;Kallenius, Gunilla
耐药（DR）和耐多药（MDR）结核病（TB）在全球范围内不断增加。在世界某些地区，10%或更多的新发结核病例是耐多药结核病。北京基因型是结核分枝杆菌的一个独特遗传谱系，分布于世界各地，并导致了MDR-TB的大规模爆发。有人提出M.结核病，如北京血统，可能有特定的适应性优势。我们调查了瑞典人群中DR北京株的存在和传播情况。所有的医生M。研究了1994年至2008年之间的结核复合菌分离株。对北京基因型的分离株进行特异性耐药突变和系统发育分析。536株DR中70株（13%）为北京基因型。大多数携带北京菌株的患者是在国外出生的，他们的原籍国反映了北京基因型最流行的国家。多重耐药在北京菌株中明显高于非北京菌株。北京基因型与katG基因、mabA-inhA-启动子和rpoB基因的特异性耐药突变相关。综合运用RD缺失、spoligotyping、IS 1547、mutT基因多态性和Rv 3135基因分析，将北京毒株分为11个基因组亚系。北京株28例（41%）分布在10个簇（每个簇2-5个）中，非北京株52%分布在簇中。24个MIRU-VNTR位点共发现北京株患者31例（45%），分布在7个群（每个群2-11例）中。接触者追踪仅在两名北京菌株患者之间建立了可能的流行病学联系。尽管瑞典发生了非北京结核菌株的大规模爆发，但北京菌株尚未站稳脚跟，尽管它靠近俄罗斯和波罗的海国家等高流行率国家。目前在瑞典引入的北京亚种可能不适合在斯堪的纳维亚人群中传播。
Drug resistant (DR) and multi-drug resistant (MDR) tuberculosis (TB) is increasing worldwide. In some parts of the world 10% or more of new TB cases are MDR. The Beijing genotype is a distinct genetic lineage of Mycobacterium tuberculosis, which is distributed worldwide, and has caused large outbreaks of MDR-TB. It has been proposed that certain lineages of M. tuberculosis, such as the Beijing lineage, may have specific adaptive advantages. We have investigated the presence and transmission of DR Beijing strains in the Swedish population. All DR M. tuberculosis complex isolates between 1994 and 2008 were studied. Isolates that were of Beijing genotype were investigated for specific resistance mutations and phylogenetic markers. Seventy (13%) of 536 DR strains were of Beijing genotype. The majority of the patients with Beijing strains were foreign born, and their country of origin reflects the countries where the Beijing genotype is most prevalent. Multidrug-resistance was significantly more common in Beijing strains than in non-Beijing strains. There was a correlation between the Beijing genotype and specific resistance mutations in the katG gene, the mabA-inhA-promotor and the rpoB gene. By a combined use of RD deletions, spoligotyping, IS1547, mutT gene polymorphism and Rv3135 gene analysis the Beijing strains could be divided into 11 genomic sublineages. Of the patients with Beijing strains 28 (41%) were found in altogether 10 clusters (2–5 per cluster), as defined by RFLP IS6110, while 52% of the patients with non-Beijing strains were in clusters. By 24 loci MIRU-VNTR 31 (45%) of the patients with Beijing strains were found in altogether 7 clusters (2–11 per cluster). Contact tracing established possible epidemiological linkage between only two patients with Beijing strains. Although extensive outbreaks with non-Beijing TB strains have occurred in Sweden, Beijing strains have not taken hold, in spite of the proximity to high prevalence countries such as Russia and the Baltic countries. The Beijing sublineages so far introduced in Sweden may not be adapted to spread in the Scandinavian population.
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