A population-based cohort study of Mycobacterium tuberculosis Beijing strains: an emerging public health threat in an immigrant-receiving country?
A population-based cohort study of Mycobacterium tuberculosis Beijing strains: an emerging public health threat in an immigrant-receiving country?
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DOI：
10.1371/journal.pone.0038431
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Long R
中科院分区：
文献类型：
--
作者：
Langlois-Klassen D;Kunimoto D;Saunders LD;Chui L;Boffa J;Menzies D;Long R
结核分枝杆菌北京菌株经常与结核病暴发和耐药性相关。然而，相互矛盾的证据和有限的研究普遍性使得很难预测北京病毒在高收入移民接收国的出现是否会对公共卫生构成更大的威胁。本研究的目的是确定北京毒株相对于加拿大境内的其他毒株是否与高风险疾病表现相关。这是一项以人群为基础的回顾性研究，研究对象为 1991 年至 2007 年加拿大一个主要移民接收省份经培养确诊的活动性结核病病例。在 1,852 例符合条件的病例中，1,826 例 (99%) 成功进行了基因分型。将人口统计学、临床和分枝杆菌学监测数据与分子诊断数据相结合。主要结果指标是疾病部位、肺空洞、痰涂片阳性、细菌载量和一线抗结核药物耐药性。共有350名（19%）患者携带北京毒株；其中 298 人（85%）出生在西太平洋地区。与非北京菌株相比，北京菌株明显更可能与多药耐药性（aOR 1.8；95% CI 1.0–3.3；p = 0.046）和多药耐药性（aOR 3.4；1.0–11.3；p = 0.049）相关。相反，北京菌株与非北京菌株相比，与呼吸道疾病（aOR 1.3；1.0–1.8；p = 0.053）、高细菌负荷（aOR 1.2；0.6–2.7）、肺空洞（aOR 1.0；0.7–1.5）、直接危及生命的结核病（aOR 0.8；0.5–1.6) 和单电阻 （aOR 0.9；0.6–1.3）。在亚组分析中，在西太平洋出生的个体中，北京菌株仅与耐多药结核病显着相关（aOR 6.1；1.2-30.4），与多耐药结核病具有临界显着性相关性（aOR 1.8；1.0-3.5；p = 0.062）。除了增加多重耐药或多重耐药结核病的风险外，在高收入移民接收国，北京菌株似乎并不比非北京菌株对公共健康构成更大的威胁。
Mycobacterium tuberculosis Beijing strains are frequently associated with tuberculosis outbreaks and drug resistance. However, contradictory evidence and limited study generalizability make it difficult to foresee if the emergence of Beijing strains in high-income immigrant-receiving countries poses an increased public health threat. The purpose of this study was to determine if Beijing strains are associated with high risk disease presentations relative to other strains within Canada. This was a retrospective population-based study of culture-confirmed active TB cases in a major immigrant-receiving province of Canada in 1991 through 2007. Of 1,852 eligible cases, 1,826 (99%) were successfully genotyped. Demographic, clinical, and mycobacteriologic surveillance data were combined with molecular diagnostic data. The main outcome measures were site of disease, lung cavitation, sputum smear positivity, bacillary load, and first-line antituberculosis drug resistance. A total of 350 (19%) patients had Beijing strains; 298 (85%) of these were born in the Western Pacific. Compared to non-Beijing strains, Beijing strains were significantly more likely to be associated with polyresistance (aOR 1.8; 95% CI 1.0–3.3; p = 0.046) and multidrug-resistance (aOR 3.4; 1.0–11.3; p = 0.049). Conversely, Beijing strains were no more likely than non-Beijing strains to be associated with respiratory disease (aOR 1.3; 1.0–1.8; p = 0.053), high bacillary load (aOR 1.2; 0.6–2.7), lung cavitation (aOR 1.0; 0.7–1.5), immediately life-threatening forms of tuberculosis (aOR 0.8; 0.5–1.6), and monoresistance (aOR 0.9; 0.6–1.3). In subgroup analyses, Beijing strains only had a significant association with multidrug-resistant tuberculosis (aOR 6.1; 1.2–30.4), and an association of borderline significance with polyresistant tuberculosis (aOR 1.8; 1.0–3.5; p = 0.062), among individuals born in the Western Pacific. Other than an increased risk of polyresistant or multidrug-resistant tuberculosis, Beijing strains appear to pose no more of a public health threat than non-Beijing strains within a high-income immigrant-receiving country.
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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。
影响因子：
3.7
作者：
Ghebremichael, Solomon;Groenheit, Ramona;Pennhag, Alexandra;Koivula, Tuija;Andersson, Emmi;Bruchfeld, Judith;Hoffner, Sven;Romanus, Victoria;Kallenius, Gunilla
通讯作者：
Kallenius, Gunilla
影响因子：
11.8
作者：
Cowley, Donna;Govender, Dhirendra;Nicol, Mark P.
通讯作者：
Nicol, Mark P.
影响因子：
9.4
作者：
Flores, Laura;Van, Tran;Gagneux, Sebastien
通讯作者：
Gagneux, Sebastien
结核分枝杆菌复杂的遗传多样性：挖掘第四个国际螺旋型数据库（SpoldB4），用于分类，种群遗传学和流行病学。
影响因子：
4.2
作者：
Brudey K;Driscoll JR;Rigouts L;Prodinger WM;Gori A;Al-Hajoj SA;Allix C;Aristimuño L;Arora J;Baumanis V;Binder L;Cafrune P;Cataldi A;Cheong S;Diel R;Ellermeier C;Evans JT;Fauville-Dufaux M;Ferdinand S;Garcia de Viedma D;Garzelli C;Gazzola L;Gomes HM;Guttierez MC;Hawkey PM;van Helden PD;Kadival GV;Kreiswirth BN;Kremer K;Kubin M;Kulkarni SP;Liens B;Lillebaek T;Ho ML;Martin C;Martin C;Mokrousov I;Narvskaïa O;Ngeow YF;Naumann L;Niemann S;Parwati I;Rahim Z;Rasolofo-Razanamparany V;Rasolonavalona T;Rossetti ML;Rüsch-Gerdes S;Sajduda A;Samper S;Shemyakin IG;Singh UB;Somoskovi A;Skuce RA;van Soolingen D;Streicher EM;Suffys PN;Tortoli E;Tracevska T;Vincent V;Victor TC;Warren RM;Yap SF;Zaman K;Portaels F;Rastogi N;Sola C
通讯作者：
Sola C
影响因子：
120.7
作者：
Bifani, PJ;Plikaytis, BB;Kreiswirth, BN
通讯作者：
Kreiswirth, BN