Extensive transmission of isoniazid resistant M. tuberculosis and its association with increased multidrug-resistant TB in two rural counties of eastern China: a molecular epidemiological study.
Extensive transmission of isoniazid resistant M. tuberculosis and its association with increased multidrug-resistant TB in two rural counties of eastern China: a molecular epidemiological study.
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中国东部两个农村县耐异烟肼结核分枝杆菌的广泛传播及其与耐多药结核病增加的关系：一项分子流行病学研究
DOI：
10.1186/1471-2334-10-43
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发表时间：
2010-02-28
影响因子：
3.7
通讯作者：
Xu B
中科院分区：
文献类型：
--
作者：
Hu Y;Hoffner S;Jiang W;Wang W;Xu B
背景
本研究旨在探讨中国东部农村地区耐异烟肼结核分枝杆菌（MTB）的分子特征及其在耐多药结核病（MDR-TB）传播中的作用。
方法
2004 - 2005年在中国东部两个农村县进行了以人群为基础的流行病学调查。总的来说，131个异烟肼耐药结核分枝杆菌分离株的分子特征的DNA测序和基因型的IS 6110限制性片段长度多态性（RFLP）和spoligotyping。
结果
在131株异烟肼耐药菌株中，有74株存在katG 315 Thr突变，耐多药结核病的可能性较大（48.6%），rpoB基因突变的可能性较大（47.3%）。Spoligotyping鉴定出80.2%的异烟肼耐药MTB分离株属于北京家族。基于IS 6110 RFLP基因分型的聚类分析显示，48.1%的异烟肼耐药菌株可分为26个簇，其中katG 315 Thr突变株的聚类比例显著高于katG野生型菌株（73%.vs.18%，OR，12.70，95%CI，6.357-14.80）。在19个集群中观察到53个耐多药结核分离株中的31个。在这些簇中，耐多药结核分离株中的异烟肼耐药性都是由于katG 315 Thr突变; 18个簇还包含单异烟肼耐药和其他异烟肼耐药分离株。
结论
这些结果表明，异烟肼耐药的结核分枝杆菌，特别是与katG 315 Thr可能聚集在一个社区，发展额外的耐利福平，并成为耐多药结核病在中国农村环境。
Background
The aim of this study was to investigate the molecular characteristics of isoniazid resistant Mycobacterium tuberculosis (MTB), as well as its contribution to the dissemination of multi-drug resistant TB (MDR-TB) in rural areas of eastern China.
Methods
A population-based epidemiological study was conducted in two rural counties of eastern China from 2004 to 2005. In total, 131 isoniazid resistant MTB isolates were molecularly characterized by DNA sequencing and genotyped by IS6110 restriction fragment length polymorphism (RFLP) and spoligotyping.
Results
The katG315Thr mutation was observed in 74 of 131 isoniazid resistant isolates and more likely to be MDR-TB (48.6%) and have mutations in rpoB gene (47.3%). Spoligotyping identified 80.2% of isoniazid resistant MTB isolates as belonging to the Beijing family. Cluster analysis by genotyping based on IS6110 RFLP, showed that 48.1% isoniazid resistant isolates were grouped into 26 clusters and katG315Thr mutants had a significantly higher clustering proportion compared to those with katG wild type (73%.vs.18%; OR, 12.70; 95%CI, 6.357-14.80). Thirty-one of the 53 MDR-TB isolates were observed in 19 clusters. Of these clusters, isoniazid resistance in MDR-TB isolates was all due to the katG315Thr mutation; 18 clusters also contained mono-isoniazid resistant and other isoniazid resistant isolates.
Conclusions
These results highlighted that isoniazid resistant MTB especially with katG315Thr is likely to be clustered in a community, develop extra resistance to rifampicin and become MDR-TB in Chinese rural settings.
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