Dominant Mycobacterium tuberculosis Lineages in Elderly Patients Born in Norway 英文参考文献.docVIP

DominantMycobacteriumtuberculosisLineagesin ElderlyPatientsBorninNorway WibekeKinander,Torbj?rnBruvik,UlfR.Dahle* NorwegianInstituteofPublicHealth,Oslo,Norway Abstract Background:DuringthepreviouscenturyNorwayhadahighincidenceoftuberculosis,butnomolecularepidemiological studies could be performed and these previously epidemic strains have been disappearing during the last decades. Currently, tuberculosis among native Norwegians is in the elimination phase, and it is still not known what type of M. tuberculosiswassoefficientlycontrolledduringthesecondhalfofthe20thcentury.However,manyelderlyNorwegian-born people stilldevelopTBthat cannotbeclustered toimportedor recentlytransmitted strainsof M. tuberculosis.Thus,the majorityofthesecasesareresultsofreactivationofdiseasethatwastransmittedmanydecadesago. Methodology/PrincipalFindings:Atotalof213strainsofM.tuberculosisisolatedduring1998–2005,frompatientsbornin Norwaybefore1950weregenotypedinthecurrentstudy.ThefindingsdemonstratedahighlyhomogenousM.tuberculosis populationamongthepatients.Atotalof40%belongedtotheT-family,were35%wereassignedtoT1sub-family(T2=0, 93%,T3=1,4%andT4=2,3%).Asmanyas35%oftheisolatesbelongedtotheHaarlemfamily,were15%wereassignedto Haarlem1and19%toHaarlem3.Theremaining25%belongedto15differentotherfamilies.TheRFLP-patternsindicated thattheisolateswerenotaresultofrecenttransmission,butratherrepresentedwellestablishedstrainsthatapparently dominatedinNorwaymanydecadesago. Conclusions/Significance: The T 1, Haarlem 1, and Haarlem 3 families of M. tuberculosis were abundant among patients borninNorwaybefore1950.TheM.tuberculosiscasesrepresentedreactivateddiseasethathadbeenacquiredbefore1994 and were likely to have been latent for several decades. Thus, the current study indicated that the T 1, Haarlem 1, and Haarlem3familiesmayhavebeencommoninNorway,whentuberculosisrepresentedaseriouspublichealththreatduring thefirsthalfofthe20thcentury. Citation: Kinander W, Bruvik T, Dahle UR (2009) Dominant Mycobact