Extensively drug-resistant tuberculosis in South Africa: genomic evidence supporting transmission in communities.
Extensively drug-resistant tuberculosis in South Africa: genomic evidence supporting transmission in communities.
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DOI：
10.1183/13993003.00246-2018
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发表时间：
2018-10
期刊：
影响因子：
--
通讯作者：
Gandhi NR
中科院分区：
文献类型：
--
作者：
Auld SC;Shah NS;Mathema B;Brown TS;Ismail N;Omar SV;Brust JCM;Nelson KN;Allana S;Campbell A;Mlisana K;Moodley P;Gandhi NR
尽管有证据表明，传播正在推动广泛耐药结核病流行，但我们对传播发生的地点和人群之间的了解有限。我们试图确定在没有流行病学联系的情况下，个体之间是否存在传播的基因组证据。我们在2011-2014年期间对南非夸祖鲁-纳塔尔省的XDR结核病患者进行了一项前瞻性研究。我们收集了社会人口学和临床数据，并根据人与人之间或医院之间的联系确定了流行病学联系。我们对结核分枝杆菌分离株进行了全基因组测序，并确定了成对单核苷酸多态性（SNP）差异。在404名参与者中，123人（30%）有人际或医院联系，剩下281人（70%）在流行病学上没有联系。人与人之间和基于医院的联系的参与者之间的中位SNP差异分别为10 （IQR 8-24）和16 （IQR 10 - 23）。未连接的参与者与其最接近的基因组连接之间的中位SNP差异为5 (IQR 3-9)；一半的非连锁参与者与至少5名参与者的snp在7个以内。大多数流行病学上不相关的XDR结核病患者具有低的成对SNP差异，与传播一致，至少有一个其他参与者。这些数据表明，许多传播可能是由社区环境中彼此不认识的个人之间的偶然接触造成的。许多广泛耐药结核病的传播可能来自互不认识的个体之间的偶然接触。
Despite evidence that transmission is driving an extensively drug-resistant (XDR) tuberculosis epidemic, our understanding of where and between whom transmission occurs is limited. We sought to determine whether there was genomic evidence of transmission between individuals without an epidemiologic connection. We conducted a prospective study of XDR tuberculosis patients in KwaZulu-Natal, South Africa, during 2011–2014. We collected sociodemographic and clinical data, and identified epidemiologic links based on person-to-person or hospital-based connections. We performed whole-genome sequencing on the Mycobacterium tuberculosis isolates and determined pairwise single nucleotide polymorphism (SNP) differences. Among 404 participants, 123 (30%) had person-to-person or hospital-based links, leaving 281 (70%) epidemiologically unlinked. The median SNP difference between participants with person-to-person and hospital-based links was 10 (IQR 8–24) and 16 (IQR 10–23), respectively. The median SNP difference between unlinked participants and their closest genomic link was 5 (IQR 3–9); half of unlinked participants were within 7 SNPs of at least five participants. The majority of epidemiologically unlinked XDR tuberculosis patients had low pairwise SNP differences, consistent with transmission, with at least one other participant. These data suggest that much of transmission may result from casual contact in community settings between individuals not known to one another. Much of XDR tuberculosis transmission may arise from casual contact between individuals not known to one another.
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影响因子：
3.7
作者：
Glynn, Judith R.;Guerra-Assuncao, Jose Afonso;Clark, Taane G.
通讯作者：
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影响因子：
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作者：
Eldholm, Vegard;Monteserin, Johana;Rieux, Adrien;Lopez, Beatriz;Sobkowiak, Benjamin;Ritacco, Viviana;Balloux, Francois
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作者：
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通讯作者：
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DOI：
10.1056/nejmoa1604544
发表时间：
2017-01-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Shah NS;Auld SC;Brust JC;Mathema B;Ismail N;Moodley P;Mlisana K;Allana S;Campbell A;Mthiyane T;Morris N;Mpangase P;van der Meulen H;Omar SV;Brown TS;Narechania A;Shaskina E;Kapwata T;Kreiswirth B;Gandhi NR
通讯作者：
Gandhi NR
影响因子：
11.8
作者：
Devaux I;Kremer K;Heersma H;Van Soolingen D
通讯作者：
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