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Drug resistant tuberculosis cases from the Copperbelt province and Northern regions of Zambia: Genetic diversity, demographic and clinical characteristics
Tuberculosis ( IF 3.2 ) Pub Date : 2021-09-02 , DOI: 10.1016/j.tube.2021.102122
Namaunga K Chisompola 1 , Elizabeth M Streicher 2 , Anzaan Dippenaar 2 , Michael G Whitfield 2 , Mathias Tembo 3 , Sydney Mwanza 3 , Robin M Warren 2 , Samantha L Sampson 2
Affiliation  

Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a major cause of death worldwide. Diverse genotypes have been demonstrated to drive the epidemiology of drug resistant (DR-) TB globally. Currently, there is limited knowledge on the genotypes and transmission dynamics of M. tuberculosis in Zambia. This study aimed to describe the genotypes of DR-TB from the Copperbelt and Northern regions of Zambia.

Molecular typing tools of insertion sequence 6110-restriction fragment length polymorphism (IS6110-RFLP) and spacer oligonucleotide typing (spoligotyping) were applied.

We demonstrate that diverse genotypes are associated with DR-TB in Zambia. The predominant genotype was lineage 4; other strains belonged to lineage 2 and 3. Genotypes previously identified as driving the epidemiology of drug susceptible TB have been identified as drivers of DR-TB. Genotyping analysis showed clustering of strains among patients from different regions of the country; suggesting that DR-TB is widespread.

Molecular findings combined with phenotypic and epidemiologic findings play a critical role in identifying circulating genotypes and possible transmission chains. Clustering of drug resistant strains was demonstrated to be 48% and 86% according to IS6110-RFLP and spoligotyping, respectively. However, gaps in clinical and demographic data skew the interpretation, and call for data collection policy improvements.



中文翻译:

来自铜带省和赞比亚北部地区的耐药结核病病例:遗传多样性、人口统计学和临床​​特征

结核分枝杆菌引起的结核病 (TB)仍然是全世界死亡的主要原因。多种基因型已被证明可推动全球耐药 (DR-) 结核病的流行病学。目前,关于赞比亚结核分枝杆菌基因型和传播动力学的知识有限。本研究旨在描述赞比亚铜带和北部地区耐药结核病的基因型。

应用了插入序列6110-限制性片段长度多态性 (IS 6110- RFLP) 和间隔寡核苷酸分型 (spoligotyping) 的分子分型工具。

我们证明了不同的基因型与赞比亚的耐药结核病有关。主要基因型是谱系 4;其他菌株属于谱系 2 和 3。以前被确定为驱动药物敏感结核病流行病学的基因型已被确定为耐药结核病的驱动因素。基因分型分析显示来自全国不同地区的患者的菌株聚集;表明耐药结核病很普遍。

分子发现与表型和流行病学发现相结合,在确定循环基因型和可能的传播链方面发挥着关键作用。根据 IS 6110 -RFLP 和 spoligotyping,耐药菌株的聚集率分别为 48% 和 86% 。然而,临床和人口统计数据的差距扭曲了解释,并呼吁改进数据收集政策。

更新日期:2021-09-12
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