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首页> 外文期刊>Tuberculosis Research and Treatment >Mycobacterium tuberculosisComplex Genotype Diversity and Drug Resistance Profiles in a Pediatric Population in Mexico
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Mycobacterium tuberculosisComplex Genotype Diversity and Drug Resistance Profiles in a Pediatric Population in Mexico

机译：墨西哥小儿结核分支杆菌的复杂基因型多样性和耐药性谱

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The aim of this study was to determine the frequency of drug resistance and the clonality of genotype patterns inM. tuberculosisclinical isolates from pediatric patients in Mexico (n=90patients from 19 states; time period—January 2002 to December 2003). Pulmonary disease was the most frequent clinical manifestation (71%). Children with systemic tuberculosis (TB) were significantly younger compared to patients with localized TB infections (mean7.7±6.2years versus15±3.4yearsP=0.001). Resistance to any anti-TB drug was detected in 24/90 (26.7%) of the isolates; 21/90 (23.3%) and 10/90 (11.1%) were resistant to Isoniazid and Rifampicin, respectively, and 10/90 (11.1%) strains were multidrug-resistant (MDR). Spoligotyping produced a total of 55 different patterns; 12/55 corresponded to clustered isolates (n=47, clustering rate of 52.2%), and 43/55 to unclustered isolates (19 patterns were designated as orphan by the SITVIT2 database). Database comparison led to designation of 36 shared types (SITs); 32 SITs (n=65isolates) matched a preexisting shared type in SITVIT2, whereas 4 SITs (n=6isolates) were newly created. Lineage classification based on principal genetic groups (PGG) revealed that 10% of the strains belonged to PGG1 (Bovis and Manu lineages). Among PGG2/3 group, the most predominant clade was the Latin-American and Mediterranean (LAM) in 27.8% of isolates, followed by Haarlem and T lineages. The number of single drug-resistant (DR) and multidrug-resistant (MDR-TB) isolates in this study was similar to previously reported in studies from adult population with risk factors. No association between the spoligotype, age, region, or resistance pattern was observed. However, contrary to a study onM. tuberculosisspoligotyping in Acapulco city that characterized a single cluster of SIT19 corresponding to the EAI2-Manila lineage in 70 (26%) of patients, not a single SIT19 isolate was found in our pediatric patient population. Neither did we find any shared type belonging to the EAI family which represents ancestral PGG1 strains within theM. tuberculosiscomplex. We conclude that the population structure of pediatric TB in our setting is different from the one prevailing in adult TB patient population of Guerrero.
机译：这项研究的目的是确定在M中的耐药性频率和基因型模式的克隆性。墨西哥儿科患者的结核病临床分​​离株（来自19个州的n = 90名患者;时间段-2002年1月至2003年12月）。肺部疾病是最常见的临床表现（71％）。系统性结核病（TB）患儿比局部结核病感染的患儿要年轻得多（平均7.7±6.2岁和15±3.4岁，P = 0.001）。在24/90（26.7％）的分离物中检测到对任何抗结核药物的耐药性; 21/90（23.3％）和10/90（11.1％）分别对异烟肼和利福平有抗药性，而10/90（11.1％）的菌株对多药耐药（MDR）。盲目的分型共产生了55种不同的模式; 12/55对应于聚簇分离株（n = 47，聚类率为52.2％），而43/55对应于非聚簇分离株（SITVIT2数据库将19个模式指定为孤儿）。数据库比较导致指定了36种共享类型（SIT）; 32个SIT（n = 65个分离物）与SITVIT2中预先存在的共享类型匹配，而新创建了4个SIT（n = 6个分离物）。根据主要遗传群体（PGG）进行的谱系分类显示，其中10％的菌株属于PGG1（Bovis和Manu谱系）。在PGG2 / 3组中，最主要的进化枝是拉丁美洲和地中海（LAM），占27.8％的分离株，其次是哈勒姆和T谱系。这项研究中的单药耐药（DR）和多药耐药（MDR-TB）分离株的数量与先前在具有危险因素的成年人群的研究中报道的数量相似。观察到窒息型，年龄，区域或抵抗模式之间没有关联。但是，与M研究相反。阿卡普尔科市的结核分型研究以70名（26％）患者的EIT2-Manila谱系对应的单个SIT19簇为特征，在我们的儿科患者群体中未发现单个SIT19分离株。我们也没有找到属于EAI家族的任何共享类型，这些共享类型代表了M中的祖先PGG1菌株。结核复合体。我们得出的结论是，在我们的研究环境中，小儿结核病的人口结构与格雷罗州成人结核病患者中普遍存在的人口结构不同。

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