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題 名 | 新科技防疫:全基因體定序技術於結核病群聚調查應用與實例=Application of Advanced Whole Genome Sequencing Technology for Tuberculosis Outbreak Investigation |
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作 者 | 蕭聿昕; 周如文; | 書刊名 | 疫情報導 |
卷 期 | 39:21 2023.11.07[民112.11.07] |
頁 次 | 頁326-335 |
關鍵詞 | 結核病; 結核菌群; 全基因體定序; 聚集監測; 群聚調查; Tuberculosis; Mycobacterium tuberculosis complex; Whole genome sequencing; Outbreak investigation; |
語 文 | 中文(Chinese) |
DOI | 10.6524/EB.202311_39(21).0001 |
中文摘要 | 結核病是空氣傳播傳染病,阻斷傳播鏈,為結核病防治極重要的關鍵。全球結核病防治已進入基因體分析的世代,透過全基因體定序(whole genome sequencing, WGS)獲得結核菌群的單一核苷酸多型性(single nucleotide polymorphism, SNP)資訊,可補強現有基因分型方法鑑別度的限制。緣此,為強化結核病聚集(cluster)事件監測效能及釐清可能的指標個案,本文敘述利用WGS進行親緣性分析,並整合疫情調查資料,訂定適用於臺灣群聚調查的SNP判定閾值:≤ 5 SNPs為明確流病相關,為必要調查對象;≤ 15 SNPs為極可能相關,視疫情可擴大疫調對象。並依資源及效益,建立群聚(outbreak)事件的實驗室檢驗流程:若由MIRU-VNTR初判為聚集且為特殊重要調查事件,則進行WGS分析。以提供疫情調查佐證,限縮所須疫調範圍,優化結核病聚集監測及群聚溯源,以落實精準結核病防疫的策略目標。 |
英文摘要 | Tuberculosis (TB) is an aerosol-transmissible disease caused by the Mycobacterium tuberculosis complex. Blocking the transmission chain is one of the key strategies to stop TB. The global tuberculosis control has entered the genomic era. For facilitating TB control, we used whole genome sequencing (WGS) to obtain single nucleotide polymorphism (SNP) information of M. tuberculosis to improve discriminative limitations of conventional genotyping methods and to strengthen the delineation of transmission networks. Based on a confirmed multidrug-resistant TB (MDR-TB) outbreak, we define SNPs differences for TB outbreak investigations. To confirm an outbreak, the transmission events between cases within clusters were calculated using thresholds of ≤ 5 (definite) and ≤ 15 (probable) SNPs difference between isolates. Depending on cost-effectiveness, an algorithm was established using mycobacterial interspersed repetitive units-variable number tandem repeat (MIRU-VNTR) and WGS as the primary and secondary genotyping, respectively. However, WGS still needs to be combined with classical epidemiological methods to improve outbreak investigations. |
本系統中英文摘要資訊取自各篇刊載內容。