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首页> 外文期刊>Journal of Clinical Microbiology >Evaluation of the Inaccurate Assignment of Mixed Infections by Mycobacterium tuberculosis as Exogenous Reinfection and Analysis of the Potential Role of Bacterial Factors in Reinfection
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Evaluation of the Inaccurate Assignment of Mixed Infections by Mycobacterium tuberculosis as Exogenous Reinfection and Analysis of the Potential Role of Bacterial Factors in Reinfection

机译：结核分枝杆菌作为外源性再感染的混合感染分配不准确的评估以及细菌因素在再感染中的潜在作用分析

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Molecular analysis of recurrent tuberculosis has revealed that a second episode may be caused by a strain of Mycobacterium tuberculosis other than that involved in the first infection, thus indicating that exogenous reinfection plays a role in recurrence. We focused on two aspects of reinfection that have received little attention. First, we evaluated whether a lack of methodological refinement could lead to inaccurate assignment of mixed infections as exogenous reinfection, in which a differential selection of each of the coinfecting strains occurred over time. We used the mycobacterial interspersed repetitive-unit–variable-number tandem-repeat (MIRU-VNTR) method to genotype 122 isolates from 40 patients with recurrent tuberculosis. We identified 11/40 (27.5%) cases with genotypic differences between the isolates involved in the sequential episodes. Major genotypic differences were found in 8/11 cases, suggesting exogenous reinfection; in the remaining 3 cases, subtle genotypic differences were observed, probably indicating microevolution from a parental strain. In all cases, only a single strain was detected for the isolate(s) from each episode, thus ruling out the possibility that reinfection could correspond to undetected mixed infection. Second, we analyzed the infectivity of a selection of 12 strains from six cases with genotypically different strains between episodes. No main differences were observed in an ex vivo model of infection between the strains involved in the first episodes and those involved in the recurrent episodes. In our setting, our results suggest the following: (i) the possibility of misassignment of mixed infection as exogenous reinfection is improbable, and (ii) bacterial infectivity does not seem to play a role in exogenous reinfection.
机译：复发性肺结核的分子分析表明，第二次发作可能是由结核分枝杆菌菌株引起的，而不是与第一次感染有关，因此表明外源性再感染在复发中起作用。我们专注于很少引起关注的两个方面的再感染。首先，我们评估了缺乏方法论上的改进是否会导致混合感染作为外源性再感染的不准确分配，其中随着时间的推移，每种共感染菌株的差异选择都会发生。我们使用分枝杆菌散布的重复单位-可变数目串联重复（MIRU-VNTR）方法对40例复发性肺结核患者的基因型122分离株进行了分析。我们确定了11/40（27.5％）例病例，这些病例在连续发作的分离株之间存在基因型差异。在8/11例中发现了主要的基因型差异，表明外源性再感染。在其余3例中，观察到细微的基因型差异，这可能表明它是由亲本菌株引起的微小进化。在所有情况下，每个事件的分离株均仅检测到一个菌株，因此排除了重新感染可能对应于未检测到的混合感染的可能性。其次，我们分析了6例病例之间在基因型上不同的菌株中选择的12株的感染性。在首次发作所涉及的菌株与复发发作所涉及的菌株之间，在体外感染模型中未观察到主要差异。在我们的研究中，我们的结果表明以下几点：（i）由于不可能进行外源性再感染而导致混合感染分配错误的可能性，并且（ii）细菌感染性似乎在外源性再感染中不起作用。

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