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地点:哈萨克斯坦的 9 个州,2001 年。目的:分析哈萨克斯坦的耐药结核杆菌分离株的遗传学联系,确定北京基因型的频率。设计:对 2001 年全国耐药监测中 9 个州的所有耐药涂阳病例进行IS6110指纹和间隔区寡核苷酸分型法(spoligotyping)分析。分离株来自 150 名病人(64名初治,86 名复治病人)。结果:8 例(5.3%)为重复感染。其余 142 株,91株(64.1%)分布在 18 个簇,提示耐药结核病的近期传播率很高。这一结果通过分析成簇菌株相似的耐药谱及病人的来源得到更进一步的证实。而且,成簇菌株中 1/3 以上为新病例。其中,70%为北京基因型,而对照组 40 例敏感株中只有 37.5%为北京基因型。结论:耐药结核病的传播是此结核病高发区耐药菌株传播所致。可以看出,北京基因型是引起哈萨克斯坦耐药结核病的主要原因,北京基因型和耐药相关。
Location: 9 states of Kazakhstan, 2001. OBJECTIVE: To analyze the genetic association of M. tuberculosis isolates in Kazakhstan and determine the frequency of Beijing genotypes. Design: IS6110 fingerprinting and spacer spoligotyping analysis of all drug-resistant smear-positive cases from 9 states in the national drug resistance surveillance in 2001. The isolates were from 150 patients (64 naive and 86 rehabilitated). Results: Eight patients (5.3%) were infected repeatedly. The remaining 142 strains and 91 strains (64.1%) distributed in 18 clusters, suggesting that the recent transmission rate of drug-resistant tuberculosis is very high. This result was further confirmed by analyzing the similar drug resistance spectrum of clustered strains and the patient’s source. Moreover, more than a third of the cluster strains were new cases. Of these, 70% were Beijing genotypes, while only 37.5% of the 40 sensitive strains in the control group were Beijing genotypes. Conclusion: The spread of drug-resistant TB is caused by the spread of drug-resistant strains in this high incidence area of TB. As can be seen, Beijing genotype is the main cause of drug-resistant TB in Kazakhstan, Beijing genotype and resistance-related.