Molecular typing of the Mycobacterium tuberculosis strains circulating in central Russia: efficiency of spoligotyping and VNTR-MIRU

Current problems of molecular epidemiology of the Mycobacterium tuberculosis strains circulating in Samara Region, Russia are discussed. A total of 190 isolates of Mycobacterium tuberculosis were typed using two PCR-based molecular methods. The cultures were isolated from civil and prison patients with pulmonary tuberculosis recruited from different tuberculosis institutions across the Samara region. The usefulness of spoligotyping and 15-locii VNTR-MIRU was assessed for genotyping of Mycobacterium in population with high prevalence of Beijing strains (67.9%) using statistical analyses that included calculation of Hunter-Gaston index. The VNTR-MIRU method was demonstrated to be more efficient and was characterized by higher discrimination (index 0.747) compare to spoligotyping (index 0.572). VNTR-MIRU loci 10, 26, 31, 39, 40 and ETR-A were mostly polymorphic and therefore recommended for use in screening. It could be performed by manual electrophoresid, provided that automated sequencing is not available.     

Identifying Mycobacterium species and strain typing using a microfluidic labchip instrument

We developed schemes for rapid identification of Mycobacterium species and strain typing using a microfluidic labchip instrument. A 439-bp region of the gene that codes for the 65-kDa heat shock protein (hsp65), which has sequence polymorphisms specific for most mycobacterial species, was examined using PCR-restriction analysis (PRA). We performed PRA in duplicate, using 2 strains each of 12 species, and observed that fragment sizes (bp) determined automatically by the instrument were consistently smaller than the correct sizes for each of the species as determined by sequence analysis (mean variance, < 7 bp). Mycobacterium tuberculosis isolates were typed with the labchip instrument using mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing, which determines the number of copies of repeated units at 12 loci in the genome based on product size after PCR amplification. Seven strains with one to six repeat copies at each locus were examined. Sizes were smaller by a mean of 13.47 bp compared with correct sizes predicted by sequence analysis, but could be used to correctly identify all strains types. Isolates of Mycobacterium chelonae and Mycobacterium abscessus were typed using randomly amplified polymorphic DNA (RAPD) electrophoresis, and patterns obtained using the labchip instrument were compared with multilocus enzyme electrophoresis (MEE) types. Patterns were distinct and reproducible for all strains except those with closely related MEE types. The labchip instrument is a versatile alternative for sizing mycobacterial DNA fragments.     

Nature of DNA polymorphism in the direct repeat cluster of Mycobacterium tuberculosis; application for strain differentiation by a novel typing method

Mycobacterium tuberculosis complex strains contain a unique chromosomal region, which consists of multiple 36bp direct repeats (DRs), which are interspersed by unique spacers 35 to 41 bp in length. In this study we investigated the nature of the DNA polymorphism of this DR cluster by sequencing part of this region in a large number of M. tuberculosis complex strains. Two types of genetic rearrangements were observed. One type consists of the variation in one or a few discrete, contiguous DRs plus spacer sequences. This variation is probably driven by homologous recombination between adjacent or distant DRs. The other type of polymorphism is probably driven by transpositional events of the insertion sequence, IS6110, which is almost invariably present in the DR cluster of M. tuberculosis complex strains. Based on the nature of the DNA polymorphism in the DR cluster, we developed a novel method of strain differentiation, direct variable repeat polymer chain reaction (DVR-PCR), which enables typing of individual M. tuberculosis strains in a single PCR. The method allows an excellent differentiation of epidemiologically unrelated isolates and, in principle, the DVR-PCR allows the detection of M. tuberculosis and strain differentiation at the same time.     

多杀性巴氏杆菌分子分型方法简述

多杀性巴氏杆菌是一种能感染多种动物甚至是人的重要革兰氏阴性病原菌。目前临床上用于多杀性巴氏杆菌诊断的分型方法主要包括血清学分型方法和分子分型方法。其中血清学分型方法主要基于免疫学实验技术建立,操作过程繁琐,技术要求高,工作量大,不适用于临床上大规模快速开展多杀性巴氏杆菌流行病学调查的需要;而基于分子生物学手段建立的分子分型方法相对于传统的血清学分型方法而言具有快速、简单、灵敏、灵活等特点,特别是某些分子分型方法与传统的分型方法形成了较为精确的对应关系,因而在临床上得到了广泛的应用。目前适用于临床上开展多杀性巴氏杆菌分离鉴定的分子分型方法主要包括多重PCR方法及多位点序列分型法(MLST),其中多重PCR方法又包括基于荚膜编码区及脂多糖外核编码簇建立的PCR方法。本文将重点就这3种常用的多杀性巴氏杆菌分子分型方法进行综述,介绍其建立原理、实现手段以及各自的优缺点,为临床上开展多杀性巴氏杆菌的流行病学调查特别是分子流行病学调查提供参考。     

Molecular inversion probes for sensitive detection of Mycobacterium tuberculosis

Nucleic acid-based detection of Mycobacterium tuberculosis infections has the potential to improve the analysis of the tuberculosis epidemiology and patient care by increasing the specificity and sensitivity of diagnosis. One potential diagnostic sequence, the DR locus, is present in all isolates of M. tuberculosis complex bacteria. It encodes no known gene product but is useful for molecular typing of M. tuberculosis because of its fortuitous absence in non-tuberculosis strains of mycobacteria. The DR locus contains a variable number of short direct repeats interspersed with non-repetitive spacers and is commonly used as a target for the spoligotyping method, a technique based on the detection of the presence or absence of distinct spacers between the repeats. In this study, we attempted to combine the specificity of molecular inversion probe (MIP) technology with the sensitivity of modified pyrosequencing readout in order to detect a short conserved 18 bp sequence included in DR locus in 25 isolates of M. tuberculosis. Additional sensitivity was obtained by introducing modifications in pyrosequencing methodology, by these means we achieved to detect 500 fg of M. tuberculosis DNA.     

Rapid culture-based methods for drug-resistance detection in Mycobacterium tuberculosis

Tuberculosis still represents a major public health problem, especially in low-resource countries where the burden of the disease is more important. Multidrug-resistant and extensively drug drug-resistant tuberculosis constitute serious problems for the efficient control of the disease stressing the need to investigate resistance to first- and second-line drugs. Conventional methods for detecting drug-resistance in Mycobacterium tuberculosis are slow and cumbersome. The most commonly used proportion method on L?wenstein-Jensen medium or Middlebrook agar requires a minimum of 3-4 weeks to produce results. Several new approaches have been proposed in the last years for the rapid and timely detection of drug-resistance in tuberculosis. This review will address phenotypic culture-based methods for rapid drug susceptibility testing in M. tuberculosis.     

A data-mining approach to spacer oligonucleotide typing of Mycobacterium tuberculosis

MOTIVATION: The Direct Repeat (DR) locus of Mycobacterium tuberculosis is a suitable model to study (i) molecular epidemiology and (ii) the evolutionary genetics of tuberculosis. This is achieved by a DNA analysis technique (genotyping), called sp acer oligo nucleotide typing (spoligotyping ). In this paper, we investigated data analysis methods to discover intelligible knowledge rules from spoligotyping, that has not yet been applied on such representation. This processing was achieved by applying the C4.5 induction algorithm and knowledge rules were produced. Finally, a Prototype Selection (PS) procedure was applied to eliminate noisy data. This both simplified decision rules, as well as the number of spacers to be tested to solve classification tasks. In the second part of this paper, the contribution of 25 new additional spacers and the knowledge rules inferred were studied from a machine learning point of view. From a statistical point of view, the correlations between spacers were analyzed and suggested that both negative and positive ones may be related to potential structural constraints within the DR locus that may shape its evolution directly or indirectly. RESULTS: By generating knowledge rules induced from decision trees, it was shown that not only the expert knowledge may be modeled but also improved and simplified to solve automatic classification tasks on unknown patterns. A practical consequence of this study may be a simplification of the spoligotyping technique, resulting in a reduction of the experimental constraints and an increase in the number of samples processed.     

Molecular mechanisms regulating persistent Mycobacterium tuberculosis infection

Establishing persistent infection and resisting elimination by the host's immune system are key factors contributing to latent infection by Mycobacterium tuberculosis. Recently, bacterial determinants regulating these processes have been identified. Here, we review molecular mechanisms regulating persistent infection and discuss the highly dynamic interaction of M. tuberculosis with the host.     

Molecular methods for typing of Helicobacter pylori and their applications

Microbial typing is a useful tool in clinical epidemiology for defining the source and route of infection, for studying the persistence and reinfection rates, clonal selection in the host and bacterial evolution. Phenotypic methods such as biotyping, serotyping and hemagglutinin typing have little discriminatory power compared to genotypic methods concerning the typing of Helicobacter pylori. Therefore great efforts have been made to establish useful molecular typing methods. In this context, the most frequently used genotypic methods are described based on our own experience and the literature: (1) restriction endonuclease analysis, (2) endonuclease analysis using pulsed-field gel electrophoresis, (3) ribotyping, (4) polymerase chain reaction (using either random primers or repetitive DNA sequence primers), and (5) polymerase chain reaction-restriction fragment length polymorphism analysis of e.g. the urease genes. Furthermore, reproducibility, discriminatory power, ease of performance and interpretation, cost and toxic procedures of each method are assessed. To date no direct comparison of all the molecular typing methods described has been performed in the same study with the same H. pylori strains. However, PCR analysis of the urease gene directly on suspensions of H. pylori or gastric biopsy material seems to be useful for routine use and applicable in specific epidemiological situations.     

A two-step strategy for molecular typing of multidrug-resistant Mycobacterium tuberculosis clinical isolates from Poland

Tuberculosis (TB) continues to be one of the most challenging public health problems in the world. An important contributor to the global burden of the disease is the emergence and spread of drug-resistant and particularly multidrug-resistant Mycobacterium tuberculosis strains (MDR), defined as being resistant to at least isoniazid and rifampicin. In recent years, the introduction of different DNA-based molecular typing methods has substantially improved the knowledge of the epidemiology of TB. The purpose of this study was to employ a combination of two PCR-based genotyping methods, namely spoligotyping and IS6110-Mtb1/Mtb2 PCR to investigate the clonal relatedness of MDR M. tuberculosis clinical isolates recovered from pulmonary TB patients from Poland. Among the 50 isolates examined, 28 (56%) were clustered by spoligotyping, whereas IS6110-Mtb1/Mtb2 PCR resulted in 16 (32%) clustered isolates. The isolates that clustered in both typing methods were assumed to be clonally related. A two-step strategy consisting of spoligotyping as a first-line test, performed on the entire pool of isolates, and IS6110-Mtb1/Mtb2 PCR typing as a confirmatory subtyping method, performed only within spoligotype-defined clusters, is an efficient approach for determining clonal relatedness among M. tuberculosis clinical isolates.     

Molecular genetic methods of typing of the Bartonellae

The primer systems for the PCR detection of four house-keeping genes of bartonellae in clinical material were developed and tested. The tactics of the species RFLP typing was also developed and tested. The scheme of the species RFLP typing of bartonellae was tested using as an example two strains for the first time isolated in Russia from patients with endocarditis and fever of uncertain origin. The results of the typing were supported by sequencing of the amplicons obtained. According to the sequencing the isolates were attributed to the sub species Bartonella vinsonii, subsp. arupensis. The necessity of molecular epidemiological analysis of bartonelloses in Russia was substantiated.     

Comprehensive proteomic profiling of the membrane constituents of a Mycobacterium tuberculosis strain

Mycobacterium tuberculosis is an infectious microorganism that causes human tuberculosis. The cell membranes of pathogens are known to be rich in possible diagnostic and therapeutic protein targets. To compliment the M. tuberculosis genome, we have profiled the membrane protein fraction of the M. tuberculosis H37Rv strain using an analytical platform that couples one-dimensional SDS gels to a microcapillary liquid chromatography-nanospray-tandem mass spectrometer. As a result, 739 proteins have been identified by two or more distinct peptide sequences and have been characterized. Interestingly, approximately 450 proteins represent novel identifications, 79 of which are membrane proteins and more than 100 of which are membrane-associated proteins. The physicochemical properties of the identified proteins were studied in detail, and then biological functions were obtained by sorting them according to Sanger Institute gene function category. Many membrane proteins were found to be involved in the cell envelope, and those proteins with energy metabolic functions were also identified in this study.     

结核分枝杆菌核糖体蛋白丙氨酸乙酰转移酶过表达菌株的构建及分析

rimI基因编码的核糖体蛋白丙氨酸乙酰转移酶(ribosomal-protein-alanine acetyltransferase,RimI)为结核分枝杆菌GCN5相关N-乙酰转移酶家族成员,其在结核分枝杆菌中的生物学功能尚不十分清楚。为探索RimI的生物学特性及其对结核分枝杆菌致病性的影响,本研究以耻垢分枝杆菌为模式菌,构建过表达结核分枝杆菌rimI基因的重组菌株Msm∷pMV261-rimI。分别培养 Msm∷pMV261-rimI菌株和对照Msm∷pMV261菌株,分析两者生长速率、菌落形态和生物膜形成的差异,以及耐受低氧、低pH值、H₂O₂、二硫苏糖醇(dithiothreitol,DTT)和0.05%～1%十二烷基硫酸钠(sodium dodecyl sulfate,SDS)等逆环境的能力;并将两种菌株分别接种于鼠巨噬细胞RAW264.7,观察两者在巨噬细胞内的存活能力。结果表明,相较于对照菌株,过表达rimI的菌株在生长前中期速率降低,生物膜早期成膜变缓,但不影响生物膜的后期成熟。同时,过表达rimI的菌株抵抗低氧、低pH值、H₂O₂等逆环境的能力增强,在巨噬细胞内的存活能力增强。结果提示,rimI基因对分枝杆菌的生物膜形成、抗逆性及细胞内生存具有重要作用,可能与结核分枝杆菌的毒力密切相关。     

Prevalence of Mycobacterium tuberculosis infection among injection drug users in Toronto

BACKGROUND: Injection drug users are at increased risk of Mycobacterium tuberculosis infection and active tuberculosis (TB). The primary objective of this study was to determine the prevalence of M. tuberculosis infection among injection drug users in Toronto, as indicated by a positive tuberculin skin test result. An additional objective was to identify predictors of a positive skin test result in this population. METHODS: A cross-sectional study was carried out involving self-selected injection drug users in the city of Toronto. A total of 171 participants were recruited through a downtown Toronto needle-exchange program from June 1 to Oct. 31, 1996. RESULTS: Of 167 subjects tested, 155 (92.8%) returned for interpretation of their skin test result within the designated timeframe (48 to 72 hours). Using a 5-mm cut-off, the prevalence rate of positive tuberculin skin test results was 31.0% (95% confidence interval 23.8% to 38.9%). Birth outside of Canada and increasing age were both predictive of a positive result. INTERPRETATION: There is a high burden of M. tuberculosis infection in this population of injection drug users. The compliance observed with returning for interpretation of skin test results indicates that successful TB screening is possible among injection drug users.