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目的探讨上海地区结核病分子流行病学特点。方法对从上海市疾病预防控制中心菌株库中随机抽取的2000-2002年各50株耐药和敏感菌株进行间隔区寡核苷酸分型(Spoligotyping) 和分枝杆菌散在分布重复单位(MIRU)基因型分型,并结合流行病学资料进行分析。结果抽样菌株中,具有特异Spoligotyping指纹图谱的北京基因型菌株在上海地区分布达89%(81/91)。未接种过卡介苗(BCG)的患者中北京基因型菌株占88.5%(54/61),接种过BCG的患者中北京基因型菌株占90%(27/30),差异无统计学意义。北京基因型菌株耐药率为45.7%(37/81),低于非北京基因型菌株的耐药率60.0%(6/10),差异无统计学意义。MIRU成簇菌株占所有菌株的62.6%(57/91)。结论北京基因型菌株在上海地区有广泛分布,北京基因型菌株与BCG接种和耐药无关,结核病患者中有部分是由于近期传播而引起的。
Objective To investigate the molecular epidemiology of tuberculosis in Shanghai. Methods Fifty isolates of drug-resistant and susceptible strains from 2000 to 2002, randomly selected from the strain database of Shanghai CDC, were used to carry out Spoligotyping and Mycobacterium Dispersion Units (MIRU) Genotyping, combined with epidemiological data analysis. Results Among the sampled strains, Beijing genotype strains with specific Spoligotyping fingerprinting were 89% (81/91) in Shanghai. Among Beijing non-BCG patients, 88.5% (54/61) were Beijing genotypes and Beijing genotypes were 90% (27/30) in BCG-vaccinated patients with no significant difference. The resistance rate of Beijing genotype strains was 45.7% (37/81), which was lower than that of non-Beijing genotypes (60.0%, 6/10). The difference was not statistically significant. MIRU clustered strains accounted for 62.6% (57/91) of all strains. Conclusion Beijing genotype strains are widely distributed in Shanghai. Beijing genotype strains have nothing to do with BCG inoculation and drug resistance. Some patients with tuberculosis are caused by the recent spread.