乙胺丁醇
乙氧酰胺
生物
吡嗪酰胺
rpoB公司
抗药性
结核分枝杆菌
肺结核
人口
利福平
异烟肼
流行病学
分子流行病学
遗传学
病毒学
医学
抗生素
基因型
环境卫生
基因
内科学
病理
作者
Luqi Wang,Bin Chen,Hui Zhou,Barun Mathema,Liang Chen,Xiangchen Li,Yongju Lu,Zhengwei Liu,Xiaomeng Wang,Weibing Wang
出处
期刊:Genomics
[Elsevier]
日期:2023-05-01
卷期号:115 (3): 110640-110640
标识
DOI:10.1016/j.ygeno.2023.110640
摘要
Understanding the emergence and evolution of drug resistance can inform public health intervention to combat tuberculosis (TB). In this prospective molecular epidemiological surveillance study from 2015 to 2021 in eastern China, we prospectively collected whole-genome sequencing and epidemiological data on TB patients. We dissect the ordering of drug resistance mutation acquisition for nine commonly used anti-TB drugs, and we found that the katG S315T mutation first appeared around 1959, followed by rpoB S450L (1969), rpsL L43A (1972), embB M306V (1978), rrs 1401 (1981), fabG1 (1982), pncA (1985) and folC (1988) mutations. GyrA gene mutations appeared after the year of 2000. We observed that the first expansion of Mycobacterium tuberculosis (M.tb) resistance population among eastern China appeared after the introduction of isoniazid, streptomycin and para-amino salicylic acid, and the second expansion after the ethambutol, rifampicin, pyrazinamide, ethionamide and aminoglycosides. We speculate these two expansions are linked with population shift historically. By geospatial analysis, we found drug-resistant isolates migrated within eastern China. With epidemiological data of clonal strains, we observed some strains can evolve continuously in individuals and transmit readily in a population. In conclusion, this study mirrored the emergence and evolution of drug-resistant M.tb in eastern China were linked to the sequence and timing of introduction of anti-TB drugs, and multiple factors may contribute to the resistant population enlarged. To resolve the epidemic of drug-resistant TB, it requires applying anti-TB drugs carefully and/or identifying resistant patients timely to prevent them from developing high-level resistance and transmitting to others.
科研通智能强力驱动
Strongly Powered by AbleSci AI