在临床诊断的肺结核患者中,Mycobacterium tuberculosis复合物的基因型和耐药性模式
Alem Alemayehu1,2,3, Liya Wassie2, Dawit Hailu Alemayehu2
1Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
与细菌学证实病例相比,临床诊断的肺结核 (TB) 患者表现出明显的Mycobacterium结核综合体 (MTBC) 遗传多样性和耐药性概况. 这突显了当前结核病诊断协议中的潜在缺口.
科学领域:
- 微生物学 微生物学
- 遗传学 是一个遗传学.
- 流行病学 流行病学
背景情况:
- 肺结核 (TB) 诊断往往依赖于临床表现,但这些患者中Mycobacterium tuberculosis Complex (MTBC) 的遗传构成和耐药性仍未得到充分研究.
- 了解临床诊断肺结核 (CDPTB) 中的MTBC多样性对于有效的治疗和控制策略至关重要.
研究的目的:
- 为了比较CDPTB和细菌学确认的肺结核 (BCPTB) 患者之间的MTBC菌株的遗传多样性和耐药性概况.
- 确定MTBC基因型中的潜在差异及其对结核病管理的影响.
主要方法:
- 一项不匹配的病例控制研究,涉及313名PTB患者 (173名CDPTB,140名BCPTB).
- 使用洛文斯坦-詹森 (LJ) 培养,GeneXpert和酸速染色分析了液样本.
- 在MTBC分离的子集上进行了体型定型,全基因组测序 (WGS) 和表型药物耐药性测试 (DST).
主要成果:
- 与BCPTB患者 (15%) 相比,CDPTB患者 (31%) 的MTBC菌株显著更为普遍.
- 与BCPTB患者 (12%) 相比,较高比例的CDPTB患者 (16.6%) 的MTBC分离物表现出表型抗结核药物耐药性,尽管这种差异在统计学上并不显著.
- 一个CDPTB病例藏着一种对所有主要抗结核病药物有抗性的Lineage 3菌株.
结论:
- 在CDPTB和BCPTB患者之间的MTBC菌株的遗传差异可能源于诊断挑战,需要进一步的基因组研究.
- 该研究在培养基阳性CDPTB患者中确定了原发性耐药结核病,目前的国家诊断方案可能忽略了这一点.
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