上海市2000-2002年91株结核分枝杆菌分子流行病学分析

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％（37181），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。

Study on the molecular epidemiology of Mycobacterium tuberculosis in Shanghai

Objective To explore the molecular-epidemiology of Mycobacterium tuberculosis in Shanghai. Methods Drug-resistant and drug-susceptible strains of M. tuberculosis were randomly selected from the bank of M. tuberculosis of Shanghai Municipal Center for Disease Control and Prevention and were genotyped by mycobacterial interspersed repetitive units(MIRU) and Spoligotyping methods. The genotyping results were analyzed and combined with epidemiological data. Results The Spoligotyping results demonstrated that 89% (81/91) of the strains belonged to the Beijing genotype. Of the patients who had received BCG-vaccination,88. 5% (54/61) infected with strains of Beijing genotype and 90.0% (27/30) of the patients were not BCG-vaccinated. However, the difference was not statistically significant. Drug-resistant rate from those strains of Beijing genotype was 45.7 (37/81), lower than that of non-Beijing genotype (60. 0% ,6/10). Again, the difference was not statistically significant. The MIRU results showed that 62.6% (57/91) were strains of clusters. Conclusion The Beijing genotype of M. tuberculosis were found to be the dominant strains in Shanghai. The associations between Beijing genotype strains and BCG vaccination or drug-resistant were not found. Results from cluster analysis suggested that some cases might belong to the newly developed cases.