余琴, 刘海灿, 赵爱兰, 李马超, 俞南, 张爱洁, 徐伟, 万康林, 魏云芳. 北京市某中学结核病聚集性疫情的实验室鉴定结果分析[J]. 疾病监测, 2022, 37(2): 206-209. DOI: 10.3784/jbjc.202104160206
引用本文: 余琴, 刘海灿, 赵爱兰, 李马超, 俞南, 张爱洁, 徐伟, 万康林, 魏云芳. 北京市某中学结核病聚集性疫情的实验室鉴定结果分析[J]. 疾病监测, 2022, 37(2): 206-209. DOI: 10.3784/jbjc.202104160206
Yu Qin, Liu Haican, Zhao Ailan, Li Machao, Yu Nan, Zhang Aijie, Xu Wei, Wan Kanglin, Wei Yunfang. Laboratory identification of tuberculosis outbreak in a middle school in Beijing[J]. Disease Surveillance, 2022, 37(2): 206-209. DOI: 10.3784/jbjc.202104160206
Citation: Yu Qin, Liu Haican, Zhao Ailan, Li Machao, Yu Nan, Zhang Aijie, Xu Wei, Wan Kanglin, Wei Yunfang. Laboratory identification of tuberculosis outbreak in a middle school in Beijing[J]. Disease Surveillance, 2022, 37(2): 206-209. DOI: 10.3784/jbjc.202104160206

北京市某中学结核病聚集性疫情的实验室鉴定结果分析

Laboratory identification of tuberculosis outbreak in a middle school in Beijing

  • 摘要:
      目的   采用实验室检测技术,分析2018年10月至2019年1月在北京市某中学结核病聚集性疫情中分离获得的菌株,为疫情的溯源和学校结核病防控提供一定的科学依据。
      方法   依据首发患者线索,对其及203名密切接触者实施实验室检测,包括结核抗体检测、γ-干扰素检测、痰涂片和痰培养,以及阳性菌株菌种鉴定、分子分型和成簇性分析等实验室研究工作。
      结果   以结核分枝杆菌实验室培养阳性为金标准,确定包括首发患者在内的共6例结核病确诊病例。 在培养阳性组中,免疫学检查显示结核抗体阳性率为50.0%,γ-干扰素阳性率为66.7%。 6株阳性菌株提取DNA后,采用多位点PCR菌种鉴定均为结核分枝杆菌,同时经12位点可变数目串联重复序列分析(MLVA)及间隔区寡核苷酸分型检测分析,结果显示5株为北京基因型,1株无结果。 MLVA结果为4株12位点拷贝数完全一致,1株仅在Qub11a 位点上相差1.6个拷贝,另外1株在ETR-A 位点和MIRU27位点各相差1个拷贝数,其余位点拷贝数均相同。
      结论   本次实验室鉴定出的6株阳性菌株,均为结核分枝杆菌,其中5株为北京基因型。 4株样品菌株间存在较大同源性,存在近期传播可能,但需进一步的测序分析。

     

    Abstract:
      Objective   To analyze the characteristics of the Mycobacterium tuberculosis isolates from a tuberculosis (TB) outbreak in a middle school in Beijing, from October 2018 to January 2019 with Laboratory detection techniques and provide evidence for the tracing, prevention and control of the TB epidemic.
      Methods   A laboratory test was conducted for the index case and 203 close contacts, including M. tuberculosis antibody detection, γ-interferon detection, sputum smear and culture, as well as the identification, molecular typing and cluster analysis of positive strains.
      Results   According to the gold standard for culture positive in laboratory, a total of 6 TB cases, including the index cases, were identified. In the culture-positive group, the immunological examination showed that the positive rate of M. tuberculosis antibody was 50%, and the positive rate of γ-interferon was 66.7%. After DNA extraction of the 6 positive strains, all the strains were identified as M. tuberculosis by multi-loci PCR. At the same time, and the 6 strains were detected by 12 loci variable number tandem repeat sequence analysis (MLVA) and the spacer (Spoligotyping) oligonucleotide method. The results showed that 5 strains belonged to Beijing genotype, and 1 strain had no result. It was found that 4 strains had same VNTR pattern of 12 loci, and one strain had 1.6 variant in Qub11a locus, another strain showed a difference of one copy number at ETR-A and MIRU27, but the copy numbers at other sites were same.
      Conclusion   The 6 positive isolates identified in this laboratory were all M. tuberculosis, and 5 strains belonged to Beijing genotype. MLVA typing analysis indicated that 4 strains shared high homology, suggesting the possibility of recent transmission and the necessity of further sequencing analysis.

     

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