Spread of drug-resistant Mycobacterium tuberculosis strains of the Beijing genotype in the Archangel Oblast, Russia
Spread of drug-resistant Mycobacterium tuberculosis strains of the Beijing genotype in the Archangel Oblast, Russia
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DOI：
10.1128/jcm.40.6.1930-1937.2002
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发表时间：
2002-06-01
影响因子：
9.4
通讯作者：
Caugant, DA
中科院分区：
文献类型：
--
作者：
Toungoussova, OS;Sandven, P;Caugant, DA
通过使用 IS6110 探针和 spoligotyping 进行限制性片段长度多态性 (RFLP) 分析，对 1998 年和 1999 年从俄罗斯大天使州肺结核患者中分离出的 119 株结核分枝杆菌进行了研究。采用BACTEC方法分析菌株的抗结核药物耐药性，并使用Inno-LiPA Rif检测与利福平耐药相关的突变。结核病测试。 RFLP分析和spoligotyping表明，53株（44.5%）菌株属于北京基因型。这些菌株表现出比该地区流行的其他基因型结核分枝杆菌菌株显着更高的耐药率。其中，北京基因型菌株中43.4%具有多重耐药性；相比之下，其他菌株中只有 10.6% 是。北京基因型的菌株中，92.5%属于簇的一部分，而其余菌株中只有33.3%属于簇。对患者医疗记录的分析表明，感染北京基因型菌株的个体在结核病诊断之前更有可能酗酒并患有慢性阻塞性肺病。多变量分析显示，这两个变量均与北京基因型菌株的感染独立相关。我们的研究表明，北京基因型菌株是大天使州结核病的重要原因，并且这些菌株的传播与耐药性的高发生率有关。
A collection of 119 strains of Mycobacterium tuberculosis isolated from patients with pulmonary tuberculosis in the Archangel Oblast, Russia, in 1998 and 1999 were studied by using restriction fragment length polymorphism (RFLP) analysis with the IS6110 probe and spoligotyping. Resistance of the strains to antituberculosis drugs was analyzed by the BACTEC method, and mutations associated with rifampin resistance were detected by using the Inno-LiPA Rif. TB test. RFLP analysis and spoligotyping demonstrated that 53 (44.5%) of the strains belonged to the Beijing genotype. These strains showed a significantly higher rate of resistance than M. tuberculosis strains of other genotypes circulating in the region. In particular, 43.4% of the strains of the Beijing genotype were multidrug resistant; in contrast, only 10.6% of the other strains were. Of the strains of the Beijing genotype, 92.5% were part of a cluster, while only 33.3% of the remaining strains were clustered. Analysis of the medical records of the patients demonstrated that individuals infected with a strain of the Beijing genotype were significantly more likely to be alcohol abusers and to have chronic obstructive pulmonary disease prior to the tuberculosis diagnosis. Multivariate analysis showed that both variables were independently associated with infection by strains belonging to the Beijing genotype. Our study demonstrated that strains of the Beijing genotype are an important cause of tuberculosis in the Archangel Oblast and that dissemination of these strains is associated with the high incidence of drug resistance.