Diversidade clínica, epidemiológica e Genética do Mycobacterium tuberculosis na região Noroeste paulista

• Ano de defesa: 2015
• Autor(a) principal: Pedro, Heloisa da Silveira Paro [UNESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual Paulista (Unesp)
• Palavras-chave em Português: Genética; Epidemiologia molecular; Tuberculose; Mycobacterium tuberculosis
• Link de acesso: http://hdl.handle.net/11449/127890

Tuberculosis is considered a high priority public health problem. There is increasing evidence that the variation in Mycobacterium tuberculosis strains play an important role in the outcome of infections by tuberculosis. Apart from describing sociodemographic, clinical, epidemiological and bacteriological aspects of tuberculosis (TB) and correlating the distribution of resistance to antituberculosis drugs, one objective of this study was to evaluate the diversity of the genotypes of M. tuberculosis isolates using the Spoligotyping (spacer oligonucleotide typing) and MIRU-VNTR (Mycobacterial Interspersed Repetitive Units variable-number tandem repeats) techniques. With respect to drug resistance, cultures of M. tuberculosis and susceptibility tests showed that strains from people previously submitted to TB treatment or infected with HIV have more resistance to drugs compared to those without these characteristics (p <0.05 ). Resistant cases are mostly pulmonary M. tuberculosis, and have positive smear test results. Molecular analysis showed that of the 377 samples, 14 MIRU-VNTR loci had complete profiles; the 10, 16, 23, 26, 27, 31, 39 and 40 loci had high discriminatory power (0.6) the 2, ETRB and Mtub21 loci were moderately discriminatory (0.3) and 4, 20 and 24 loci had low discriminatory power (0.3). Ninety-two different patterns were observed in the 250 M. tuberculosis isolates analyzed by spoligotyping and different families were identified as Haarlem (H), Latin American and Mediterranean (LAM), T Family, undesignated (U), S lineage and X Family. Significant genetic variability was observed in M. tuberculosis isolates circulating in the northwestern region of Sao Paulo State when analyzed by spoligotyping and MIRU-VNTR