文章摘要
刘健,王峥,温艳,田秀君,陈小华,李桓英,翁小满.麻风分枝杆菌基因分型及其多个患者家庭内传播的研究[J].中华流行病学杂志,2007,28(7):649-655
麻风分枝杆菌基因分型及其多个患者家庭内传播的研究
Study on genotyping of Mycobacterium leprae and families with multi-cases
收稿日期:2006-12-06  出版日期:2014-09-18
DOI:
中文关键词: 麻风病  分子流行病学  基因分型  传播链
英文关键词: Leprosy  Molecular epidemiology  Genotyping  Transmission chain
基金项目:NIH(5R01AI63457-3)和美国HEISER基金会资助
作者单位E-mail
刘健 首都医科大学附属北京友谊医院, 北京热带医学研究所, 100050 wengxiaoman@sina.com 
王峥 首都医科大学附属北京友谊医院, 北京热带医学研究所, 100050  
温艳 首都医科大学附属北京友谊医院, 北京热带医学研究所, 100050  
田秀君 首都医科大学附属北京友谊医院, 北京热带医学研究所, 100050  
陈小华 首都医科大学附属北京友谊医院, 北京热带医学研究所, 100050  
李桓英 首都医科大学附属北京友谊医院, 北京热带医学研究所, 100050  
翁小满 首都医科大学附属北京友谊医院, 北京热带医学研究所, 100050  
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中文摘要:
      目的 探讨在特定地区和时期内采用多位点可变串联重复序列(VNTR)分析(MLVA)对麻风菌基因分型,以评价麻风病传播链.方法 从云南省丘北县2002-2006年收集的患者皮损中提取麻风菌DNA,采用AC9、6-7,GTA9,AT17,AC8a,AT15,AT18七个VNTR位点的MLVA基因分型,观察不同基因型与地理分布的关系;与现场流行病学调查结合,开展传播链的研究.结果 (1)系统发育树分析揭示:依据GTA9等位基因型的变化,可分为GTA9位点为9,11-13,15-26,>26的A、B、C、D和E菌株.A菌株的GTA9等位基因型均为9,命名为A株.A株聚集分布在该县的北部,B株聚集分布在西北部,但C、D和E菌株基因型多变,散在分布.(2)该县北、西北部的5个高发家庭内的菌株为相同的A株.同一高发家庭内的患者,其菌株VNTR基因型一致或相似,但其他高发家庭之间的菌株基因型不相同.(3)在总菌株中,A菌株占有较高比例,且地理分布聚集,近期仍在传播.结论 无论从家庭内或较小区域内收集菌株的分型结果显示,VNTR基因分型适合麻风菌分型和短传播链的研究.优势菌株或聚集株均为高发家系中发现的,因此推测高发家系可能作为乡村中的麻风菌的疫源和传染源.但需要较长时期证实A菌株是否为优势株.
英文摘要:
      Objective Multiple locus variable number-tandem repeat (VNTR) analysis (MLVA) had been proposed as a means of strain typing for tracking of source and studying the transmission chain of pathogens.However,empirical data for a defined population from scale and duration were lacking for studying the transmission chain of leprosy.Methods MLVA on 7 VNTR loci was applied to the strain typing on prevalent Mycobacterium leprae isolates collected from Qiubei county,Yunnan province during 2002-2006 in the study on the relationship between geographic distribution and genotypes of M.leprae. The strain typing,combined with conventional epidemiological investigation was performed to trace the transmission chain.Results (1) Phylogenetic analyses through application of PAUP 4.0,The M.leprae were grouped into A,B,C,D and E strains according to the aUelic range 9,11-13,15-26 and26 on the GTA9 locus.The strains with 9 copies on GTA9 locus,was named A.(2) Genotypes of strains from the five multi-case families located at North and North-West parts were similar and belonged to A strains. VNTR patterns of intra-family were identical or similar but not identical inter-family.(3) Not only A cluster appeared higher proportion in total isolates hut also distributes cluster,indicating ongoing transmission from recent findings.Conclusion VNTR strain typing was suitable to trace the short chain of transmission in both small area and intra-families.Multi-case families might constitute epidemic loci and source of M.leprae in villages,causing the predominant strain or cluster which tends to be those identified in multi-case families and resulted in the spreading of leprosy.A long-term study was underway to reveal whether A strain was predominant strain and to observe the evolution of M.leprae in this spatially and temporally defined endemic population.
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