Mycobacterium tuberculosis Complex Genotype Diversity and Drug Resistance Profiles in a Pediatric Population in Mexico.
Mycobacterium tuberculosis Complex Genotype Diversity and Drug Resistance Profiles in a Pediatric Population in Mexico.
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DOI：
10.1155/2011/239042
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发表时间：
2011-01-01
影响因子：
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通讯作者：
Gutierrez Castrellon, Pedro
中科院分区：
文献类型：
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作者：
Macias Parra, Mercedes;Kumate Rodriguez, Jesus;Gutierrez Castrellon, Pedro
本研究的目的是确定耐药的频率和基因型模式的克隆性M。来自墨西哥儿科患者的结核病临床分离株（n = 90例患者，来自19个州;时间段-2002年1月至2003年12月）。肺部疾病是最常见的临床表现（71%）。与局限性结核感染患者相比，系统性结核（TB）儿童明显更年轻（平均7.7 ± 6.2岁对15 ± 3.4岁，P = 0.001）。在24/90株（26.7%）菌株中检测到对任何抗结核药物的耐药性; 21/90株（23.3%）和10/90株（11.1%）分别对异烟肼和利福平耐药，10/90株（11.1%）菌株为多重耐药（MDR）。Spoligotyping共产生了55种不同的模式; 12/55对应于聚类分离株（n = 47，聚类率为52.2%），43/55对应于未聚类分离株（19种模式被SITVIT 2数据库指定为孤儿）。数据库比较导致指定了36个共享型（SIT）; 32个SIT（n = 65株分离株）与SITVIT 2中预先存在的共享型匹配，而4个SIT（n = 6株分离株）是新创建的。基于主要遗传群（PGG）的谱系分类显示，10%的菌株属于PGG 1（牛和马努谱系）。在PGG 2/3群中，最主要的分支是拉丁美洲和地中海（LAM），占27.8%，其次是哈勒姆和T谱系。本研究中的单药耐药（DR）和多药耐药（MDR-TB）分离株的数量与先前在有风险因素的成人人群中报告的研究相似。未观察到spoligotype，年龄，地区或耐药模式之间的关联。然而，与对M.在Acapulco市的结核病spoligotyping中，在70名（26%）患者中特征为对应于EAI 2-Manila谱系的单个SIT 19簇，在我们的儿科患者群体中未发现单个SIT 19分离株。我们也没有发现属于EAI家族的任何共享型，其代表M内的祖先PGG 1菌株。肺结核综合征我们的结论是，儿童结核病的人口结构，在我们的设置是不同的流行在成人结核病患者人群的格雷罗。
The aim of this study was to determine the frequency of drug resistance and the clonality of genotype patterns in M. tuberculosis clinical isolates from pediatric patients in Mexico (n = 90 patients from 19 states; time period-January 2002 to December 2003). Pulmonary disease was the most frequent clinical manifestation (71%). Children with systemic tuberculosis (TB) were significantly younger compared to patients with localized TB infections (mean 7.7 ± 6.2 years versus 15 ± 3.4 years P = 0.001). Resistance to any anti-TB drug was detected in 24/90 (26.7%) of the isolates; 21/90 (23.3%) and 10/90 (11.1%) were resistant to Isoniazid and Rifampicin, respectively, and 10/90 (11.1%) strains were multidrug-resistant (MDR). Spoligotyping produced a total of 55 different patterns; 12/55 corresponded to clustered isolates (n = 47, clustering rate of 52.2%), and 43/55 to unclustered isolates (19 patterns were designated as orphan by the SITVIT2 database). Database comparison led to designation of 36 shared types (SITs); 32 SITs (n = 65 isolates) matched a preexisting shared type in SITVIT2, whereas 4 SITs (n = 6 isolates) were newly created. Lineage classification based on principal genetic groups (PGG) revealed that 10% of the strains belonged to PGG1 (Bovis and Manu lineages). Among PGG2/3 group, the most predominant clade was the Latin-American and Mediterranean (LAM) in 27.8% of isolates, followed by Haarlem and T lineages. The number of single drug-resistant (DR) and multidrug-resistant (MDR-TB) isolates in this study was similar to previously reported in studies from adult population with risk factors. No association between the spoligotype, age, region, or resistance pattern was observed. However, contrary to a study on M. tuberculosis spoligotyping in Acapulco city that characterized a single cluster of SIT19 corresponding to the EAI2-Manila lineage in 70 (26%) of patients, not a single SIT19 isolate was found in our pediatric patient population. Neither did we find any shared type belonging to the EAI family which represents ancestral PGG1 strains within the M. tuberculosis complex. We conclude that the population structure of pediatric TB in our setting is different from the one prevailing in adult TB patient population of Guerrero.