赵竟男, 江友桥, 付军, 何旺瑞, 万义友. 从病原学角度分析某高校结核病疫情传播情况[J]. 凯发娱乐加盟代理. DOI: 10.3784/jbjc.202308020392
引用本文: 赵竟男, 江友桥, 付军, 何旺瑞, 万义友. 从病原学角度分析某高校结核病疫情传播情况[J]. 凯发娱乐加盟代理. DOI: 10.3784/jbjc.202308020392
Zhao Jingnan, Jiang Youqiao, Fu Jun, He Wangrui, Wan Yiyou. Transmission of Mycobacterium tuberculosis in a tuberculosis outbreak in a university from perspective of etiology[J]. Disease Surveillance. DOI: 10.3784/jbjc.202308020392
Citation: Zhao Jingnan, Jiang Youqiao, Fu Jun, He Wangrui, Wan Yiyou. Transmission of Mycobacterium tuberculosis in a tuberculosis outbreak in a university from perspective of etiology[J]. Disease Surveillance. DOI: 10.3784/jbjc.202308020392

从病原学角度分析某高校结核病疫情传播情况

Transmission of Mycobacterium tuberculosis in a tuberculosis outbreak in a university from perspective of etiology

  • 摘要:
    目的 从病原学角度分析江西省某高校一起学校结核病疫情的传播情况,探讨两种基因分型方法在学校结核病疫情处置中的作用。
    方法 对2022年江西省某高校一起结核病疫情处置可疑者筛查对象进行涂片、分离培养、Xpert MTB/RIF检测,对获得16株分离培养阳性菌株使用散在分布重复单位及可变数目串联重复序列(MIRU-VNTR)方法及全基因组测序进行基因分型,分析耐药情况及分型特征,确定传播链。
    结果 16株分离培养阳性菌株中13株鉴定为结核分枝杆菌,13株结核分枝杆菌经MIRU-VNTR检测均鉴定为北京基因型,全基因组测序为 Lineage 2 家系。 两种基因分型方法均将13株结核分枝杆菌分为3个传播链,且结果一致,其中传播链1即最大的传播链包含9株菌,均发生链霉素耐药基因rrs A514C突变;传播链2包含3株菌,均发生了利福平耐药基因rpoB H445N突变;而传播链3仅包含1株菌,其在rpoB 基因发生了 D190A突变。通过传统流行病学调查方法如各病例既往共同出现地点判断是否为一起疫情与基于病原基因分型的判断结果并不完全一致。
    结论 VNTR基因分型方法和全基因组测序方法是判断结核病近期传播的有利工具。 分子流行病学方法应作为传统流行病学的补充,可更加精准的鉴定近期传播情况。

     

    Abstract:
    Objective To evaluate the performance of two genotype methods in responding the tuberculosis (TB) outbreak in school, by analysis of the transmission of Mycobacterium tuberculosis in an outbreak in a university in Jiangxi province from the perspective of etiology.
    Methods In 2022, smear microscopy, culture, and Xpert MTB/RIF were carried out in TB case screening in the TB outbreak response in the university. Mycobacterial interspersed repetitive unit-variable number tandem repeats (MIRU-VNTR) and whole genome sequencing (WGS) were performed for 16 isolated strains of M. tuberculosis. Drug resistance and genotyping characteristics were analyzed to identify the transmission chain.
    Results In the16 culture positive strains, 13 were identified as M. Tuberculosis. All the 13 strains were identified to belong Beijing genotype by using VNTR and Lineage 2 family by WGS. A total of 3 recent transmission chains were identified by either VNTR or WGS. Chain 1, the largest transmission chain, included 9 strains with rrs A514C mutation associated with streptomycin resistance.. Chain 2 included 3 strains with rpoB H445N mutation associated with rifampicin resistance, while chain 3 only included 1 strain with rpoB D190A mutation. The result of epidemiological survey to identify the disease outbreak by the area distribution of the cases was consistent with that of pathogen genotyping in this study.
    Conclusion VNTR and WGS are useful tools to identify the recent transmission of TB. Molecular epidemiological method can be complementary to traditional epidemiology method for the more accurate identification of the recent TB transmission.

     

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