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首页> 美国卫生研究院文献>Eurosurveillance >A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria Romania and Germany in 2014 using classic genotyping and whole genome sequencing methods: lessons learnt
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A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria Romania and Germany in 2014 using classic genotyping and whole genome sequencing methods: lessons learnt

机译：2014年通过经典基因分型和全基因组测序方法对奥地利罗马尼亚和德国的多药耐药结核病群进行了跨境联合调查：经验教训

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Molecular surveillance of multidrug-resistant tuberculosis (MDR-TB) using 24-loci MIRU-VNTR in the European Union suggests the occurrence of international transmission. In early 2014, Austria detected a molecular MDR-TB cluster of five isolates. Links to Romania and Germany prompted the three countries to investigate possible cross-border MDR-TB transmission jointly. We searched genotyping databases, genotyped additional isolates from Romania, used whole genome sequencing (WGS) to infer putative transmission links, and investigated pairwise epidemiological links and patient mobility. Ten isolates from 10 patients shared the same 24-loci MIRU-VNTR pattern. Within this cluster, WGS defined two subgroups of four patients each. The first comprised an MDR-TB patient from Romania who had sought medical care in Austria and two patients from Austria. The second comprised patients, two of them epidemiologically linked, who lived in three different countries but had the same city of provenance in Romania. Our findings strongly suggested that the two cases in Austrian citizens resulted from a newly introduced MDR-TB strain, followed by domestic transmission. For the other cases, transmission probably occurred in the same city of provenance. To prevent further MDR-TB transmission, we need to ensure universal access to early and adequate therapy and collaborate closely in tuberculosis care beyond administrative borders.
机译：在欧洲联盟使用24位MIRU-VNTR分子对耐多药结核病（MDR-TB）进行分子监测表明发生了国际传播。 2014年初，奥地利检测到了由五个分离株组成的分子耐多药结核病群集。与罗马尼亚和德国的联系促使这三个国家共同研究可能的跨界耐多药结核病传播。我们搜索了基因分型数据库，对来自罗马尼亚的其他分离株进行了基因分型，使用全基因组测序（WGS）推断推定的传播联系，并调查了成对流行病学联系和患者流动性。来自10位患者的10个分离株具有相同的24位MIRU-VNTR模式。在这个集群中，WGS定义了两个亚组，每个亚组分别有四个患者。首例患者包括来自罗马尼亚的耐多药结核病患者，该患者曾在奥地利寻求医疗服务，两名患者来自奥地利。第二位患者包括两个流行病学相关的患者，他们生活在三个不同的国家，但在罗马尼亚拥有相同的血统。我们的研究结果强烈表明，奥地利公民中的两起病例是由新引入的耐多药结核病菌株引起的，然后是国内传播。对于其他情况，传播可能发生在同一出处。为了防止进一步的耐多药结核病传播，我们需要确保普遍获得早期和适当的治疗，并在行政边界之外在结核病护理方面密切合作。

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