【摘要】 目的:探讨北京/W系结核分枝杆菌在北京市昌平区的流行特征。方法:连续收集北京市昌平区2004年1月1日至2006年12月31日的结核分枝杆菌分离株336株,采用Spoligotyping和多重PCR法对其进行分型及亚分型;同时采用谱系定义靶标RD105、RD181、RD150、RD142和Real-timePCR方法进行分型和亚分型,并分析北京/W系的2个亚系与其对应患者年龄、出生地、抗结核药物敏感谱和卡介苗(BCG)接种情况之间的关系。结果:2种方法对该地区结核分枝杆菌分型及亚分型结果完全一致,均为:299株为北京/W系和37株为非北京/W系结核分枝杆菌;在北京/W系结核分枝杆菌中,存在RD181的非典型北京菌株47株(15.7%),而相对现代的缺失RD181的W菌/典型北京家族菌株252株(84.3%);在W菌/典型北京家族菌株中,RD150和RD142缺失的菌株分别为168和173株。W菌/典型北京家族菌株和非典型北京菌株2个亚系的分布与患者出生地、BCG接种情况、年龄以及抗结核药物敏感谱(链霉素、异烟肼、利福平和乙胺丁醇)均无关(χ2分别为0.530、1.623、2.180、<0.001、0.849、0.038和0.006,P均>0.05)。结论:初步绘制出北京市昌平区结核分枝杆菌的系统进化树,其中北京/W系呈现较为明显的优势。北京/W系中较现代的W菌/典型北京家族菌株又占明显优势。以RD105为靶标的Real-timePCR方法鉴定北京/W系结核分枝杆菌快速、准确。更多还原

【Abstract】 Aim:To explore the characteristics of epidemiology of Beijing/W lineage Mycobacterium tuberculosis(M.tb) isolated strains in Changping,Beijing.Methods:A total of 336 M.tb isolated strains were collected in succession from 2004 to 2006 in Changping,Beijing,and defined to be Beijing lineage M.tb by Spoligotyping and RD105 using real time PCR.Beijing lineage M.tb was further subdivided into two sub-groups as atypical Beijing strains and W strain/typical family strains by RD181 using same PCR method.W strain/typical family strains were finally divided by RD150 and RD142.The associations of sub-groups(atypical Beijing strains and W strain/typical family strains) with patients’ drug resistance,place of birth,BCG vaccination and age were assessed.Results:89.0%(299/336) strains were W/Beijing lineage,and 11.0%(37/336) were not W/Beijing lineage by the two methods,and using them the identification result was consistent.In W strain/typical Beijing family strains,15.7%(47/299) were "old" atypical Beijing strains with presence of RD181,and 84.3%(252/299) were "modern" W strain/typical family strains,deleting RD181.In W strain/typical family strains,168 and 173 M.tb strains was deleted in RD150 and RD142,respectively.There were no significant differences of place of birth,BCG vaccination,age and patient’s drug resistance between the two sub-groups(χ2 was 0.530,1.623,2.180,<0.001,0.849,0.038,and 0.006,P>0.05).Conclusion:The phylogeny tree of M.tb in Changpin,Beijing is primarily described,where W/Beijing lineage strains are dominated.However the W strain/typical Beijing family strains are of preponderance again.RD105 using real time PCR is fast and exactly identified to Beijing/W lineage M.tb.更多还原