Genotyping and molecular characteristics of multidrug-resistant Mycobacterium tuberculosis isolates from China

Zhang, Zhijian; Lu, Jie; Liu, Min; Wang, Yufeng; Qu, Geping; Li, Hongxia; Wang, Jichun; Pang, Yu; Liu, Changting; Zhao, Yanlin

doi:10.1016/j.jinf.2014.11.008

Cited by 31 publications

(47 citation statements)

References 53 publications

(53 reference statements)

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“…In a recent population-based molecular epidemiologic study in China, researchers found that Beijing genotype strains were strongly associated with genotypic clustering, suggesting that Beijing strains favor transmission (16). Similar results were observed in another study conducted with MDR isolates from China (18). Hence, the increased human-to-human transmission of Beijing strains may be responsible for the epidemic of this genotype in China.…”

Section: Discussionsupporting

confidence: 63%

“…Hence, the upregulated virulence of Beijing genotype strains may play an important role in the expansion of the successful lineage. On the other hand, one hypothesis for the predominance of the Beijing genotype is that it has acquired mechanisms to circumvent the protective effect of the Mycobacterium bovis BCG vaccine (13,18). The wide vaccination with BCG in China might be a selective advantage in the transmission of the Beijing genotype.…”

Section: Discussionmentioning

confidence: 99%

“…Second, the increased proportion of Beijing genotype strains from 2000 to 2010 is mostly attributed to the growing number of modern Beijing genotype strains rather than ancient Beijing strains. A series of reports have described that the genetic heterogeneity of the Beijing M. tuberculosis lineage is responsible for the different pathogenic and drug-resistant features (18,24). Several studies that compared the virulence levels of different branches of the Beijing genotype concluded that modern Beijing strains induced more rapid disease progression and more severe lung pathology than ancient Beijing strains (25,26).…”

Section: Discussionmentioning

confidence: 99%

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Genotyping and Prevalence of Pyrazinamide- and Moxifloxacin-Resistant Tuberculosis in China, 2000 to 2010

Pang

Zhang

Wang

et al. 2017

Antimicrob Agents Chemother

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We investigated the prevalence, trends, and risk factors for pyrazinamide (PZA) and moxifloxacin (MOX) resistance among tuberculosis (TB) cases in China and also analyzed the population structure of Mycobacterium tuberculosis strains. All the M. tuberculosis strains enrolled in this study were collected from the national TB prevalence surveys. Each strain was genotyped by analyzing the regions of RD105 and IS6110 in the NTF region. The Bactec MGIT 960 system was used to detect the drug susceptibility of M. tuberculosis isolates to PZA and MOX. Based on the genotyping results, 241 (66.4%) strains were classified as Beijing genotype in 2000, which was significantly lower than in 2010 (76.2%, P Ͻ 0.01). The proportion of the modern Beijing genotype increased significantly from 49.6% in 2000 to 68.1% in 2010 (P Ͻ 0.01), while no significant difference was observed in the rate of ancient Beijing genotype between 2000 and 2010 (P ϭ 0.676). In addition, we found that the proportion of PZA resistance in 2010 (15.0%) was significantly higher than that in 2000 (9.6%, P ϭ 0.04). For MOX, there were more MOX-resistant isolates detected in 2010 (7.7%) than in 2000 (3.0%). In conclusion, our data demonstrate that the Beijing genotype was the predominant M. tuberculosis lineage during the past decade. The proportion of Beijing genotype isolates significantly increased from 2000 to 2010, largely due to an increase in the modern Beijing sublineage. In addition, resistance to PZA and MOX increased significantly in China between 2000 and 2010.

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Genotyping and Prevalence of Pyrazinamide- and Moxifloxacin-Resistant Tuberculosis in China, 2000 to 2010

Pang

Zhang

Wang

et al. 2017

Antimicrob Agents Chemother

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“…Due to the unsatisfactory public health setting, the rate of BCG vaccination among children in the 1990s in Lishui was lower than that in other regions of Zhejiang. Numerous literatures reported that BCG vaccination might be a positive selective force favoring the spread of the Beijing genotype [28, 29]. Hence, we hypothesize that the low proportion of BCG vaccination may be responsible for the low prevalence of Beijing genotype in this area.…”

Section: Discussionmentioning

confidence: 83%

“…There were several potential reasons responsible for this observation. On one hand, Beijing genotype strains have two major evolutionary lineages, ancient and modern Beijing genotypes [29]. Despite sharing the similar spoligotyping profiles, these two lineages displayed different pathogenic and drug resistant features [29].…”

Section: Discussionmentioning

confidence: 99%

A First Insight into the Genetic Diversity and Drug Susceptibility Pattern of Mycobacterium tuberculosis Complex in Zhejiang, China

Liu

Chen

et al. 2016

BioMed Research International

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In this study, our aim was to determine the predominant genotypes among the Mycobacterium tuberculosis (MTB) strains circulating in Zhejiang Province. In addition, we also sought to determine the potential associations between MTB genotypes and susceptibility to first-line drugs. Out of these isolates, 673 (71.6%) were classified into the Beijing genotype, while the other 267 (28.4%) were from non-Beijing families. The highest proportion of Beijing genotype was found in Huzhou (80.0%) and the lowest in Lishui (48.3%). Statistical analysis revealed that there was a significant difference in the prevalence of Beijing genotype among different regions (χ 2 = 17.57, P = 0.04). In addition, the overall proportions of drug resistance to INH, RIF, SM, and EMB were 13.2% (124/940), 21.8% (75/940), 3.4% (32/940), and 5.9% (55/940) in Zhejiang, respectively. Further comparison revealed that there was no significant difference in drug susceptibility profiles between Beijing and non-Beijing strains (P > 0.05). In conclusion, we describe the genetic diversity and drug susceptibility pattern of MTB in Zhejiang for the first time. Our data demonstrate that Beijing genotype is the predominant lineage in Zhejiang, while the distribution of Beijing-genotype strains shows geographic diversity. In addition, no correlation is observed between Beijing genotype and anti-TB drug resistance.

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Main Complications of AECHB and Severe Hepatitis B (Liver Failure)

Song

Zhu

et al. 2019

Acute Exacerbation of Chronic Hepatitis B

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This chapter describes the clinical features, and diagnosis of complications in AECHB including secondary bacterial infections, coagulation disorder, water electrolyte disorder, hepatorenal syndrome, hepatic encephalopathy, hepatopulmonary syndrome and endotoxemia Patients with severe hepatitis have impaired immunity and are therefore vulnerable to all kinds of infections. After infection, these patients may experience shock, DIC and multiple organ failure, all of which seriously affect their prognosis and are major causes of death. Concurrent infections consist primarily of infections of the lungs, intestines, biliary tract, and urinary tract, as well as spontaneous bacterial peritonitis and sepsis. Severe hepatitis may reduce the synthesis of coagulation factors and enhance their dysfunction and increase anticoagulants and platelet abnormalities, leading to coagulopathy. Infection, hepatorenal syndrome and complications can further aggravate coagulopathy, resulting in DIC and seriously affecting patient prognosis. Hepatorenal syndrome, which is characterized by renal failure, hemodynamic changes in arterial circulation and abnormalities in the endogenous vascular system, is a common clinical complication of end-stage liver disease, and one of the important indicators for the prognosis of patients with severe hepatitis. Water electrolyte disorder (water retention, hyponatremia, hypokalemia, hyperkalaemia) and acid-base imbalance are common in patients with severe hepatitis. These internal environment disorders can lead to exacerbation and complication of the illness. Hepatic encephalopathy is a neurological and psychiatric anomaly syndrome based on metabolic disorder, and an important prognostic indicator for patients with severe hepatitis. The hepatopulmonary syndrome is an important vascular complication in lungs due to systemic hypoxemia in patients with cirrhosis and portal hypertension. The majority of patients with HPS are asymptomatic. Long-term oxygen therapy remains the most frequently recommended therapy for symptoms in patients with severe hypoxemia. Endotoxemia, an important complication of severe hepatitis, is not only a second hit to the liver, but also leads to other complications including SIRS and MODS.

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Genotyping and molecular characteristics of multidrug-resistant Mycobacterium tuberculosis isolates from China

Cited by 31 publications

References 53 publications

Genotyping and Prevalence of Pyrazinamide- and Moxifloxacin-Resistant Tuberculosis in China, 2000 to 2010

Genotyping and Prevalence of Pyrazinamide- and Moxifloxacin-Resistant Tuberculosis in China, 2000 to 2010

A First Insight into the Genetic Diversity and Drug Susceptibility Pattern of Mycobacterium tuberculosis Complex in Zhejiang, China

Main Complications of AECHB and Severe Hepatitis B (Liver Failure)

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