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目的应用全基因组测序技术解析耐多药结核分枝杆菌的传播路径。方法对2009—2012年上海市一起经VNTR分型鉴定的耐多药结核病传播案例中8例簇病例进行全基因组测序,描述耐多药结核分枝杆菌的传播路径。结果该起传播案例中源病例是1例复发耐多药结核病患者,在3年内传播耐药菌株导致另外至少7例患者发病。结论全基因组测序技术可以弥补传统流行病学调查与基因分型技术的不足,准确地描述结核病传播的方向与细节,鉴定传染源与缺失病例,有助于准确揭示耐多药结核病的传播路径。
Objective To analyze the transmission pathways of multidrug-resistant Mycobacterium tuberculosis using genome-wide sequencing. Methods Eight cluster cases of MDR-TB cases in Shanghai from 2009 to 2012 that were identified by VNTR typing were sequenced to describe the transmission pathways of multidrug-resistant Mycobacterium tuberculosis. Results The source case of this case of transmission was one case of relapsed multidrug-resistant tuberculosis. Transmission of drug-resistant strains within three years resulted in the onset of an additional at least seven cases. Conclusion Genome-wide sequencing can make up for the shortcomings of traditional epidemiological investigation and genotyping techniques, accurately describe the direction and details of tuberculosis transmission, identify the source of infection and the deletion cases, and help to reveal the transmission path of MDR-TB.