Fudan University reveals the micro-evolution of tuberculosis bacteria in patients with multidring

On May 4, the reporter learned from Fudan University that the team of Professor Gao Qian of the University's School of Basic Medicine used ultra-deep whole genome sequencing technology to select 12 representative TB patients from a queue of 52 TB patients to detect and track the dynamic changes of more than 1.5% of the TB bacteria population at different points in the treatment. At the same time, using method models such as population genetics and Markov chain, the micro-evolutionary dynamic process of tuberculosis bacteria in patients with effective multidration and non-effective multidrage co-use was analyzed and compared. The results of the research were published online
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of drug resistance is a huge challenge to TB prevention and control facing the world. In multidration, although more than 85% of TB patients can be successfully cured, we do not know whether the TB bacteria in patients have undergone micro-evolution, i.e. before and after treatment of TB bacteria there is a genetic difference? At the same time, the drug resistance rate of people with re-treatment of tuberculosis is about 5 times higher than that of people who are initially treated with tuberculosis, suggesting that TB bacteria may have been drug-resistant in patients, but these micro-evolutionary processes have been unclear.
, Gao Qian's team conducted an in-depth study of the drug-resistant micro-evolution of TB bacteria in patients during treatment. The study found that there are a large number of "transient" low-frequency mutations in the TB bacteria population (i.e., detected only at a certain point in time), indicating that TB bacteria have accumulated a large pool of mutations and may become a source of drug-resistant mutations; And the TB bacteria population is genetically stable, no screening for drug-resistant mutations is detected, while under "non-effective multi-drug use", TB bacteria undergo a very different micro-evolutionary process, which is manifested in significant concentration of drug-resistant mutations, continuous screening, and evolution from low concentration to high concentration of drug resistance.
currently commonly used drug sensitivity experiments in China take 1-2 months to obtain results, and it is more difficult to achieve in the course of treatment according to drug resistance changes to adjust treatment options. Therefore, it is common for drug resistance accumulation to occur during treatment.
The study is the first to depict the diametrically opposed evolutionary dynamics of TB bacteria in patients with "effective" and "non-effective" multidrage strains: the former manifests it as a strong purification option that prevents the gain of resistance, while the latter shows a positive choice for drug-resistant mutations, the accumulation and accumulation of drug-resistant mutations. Co-first author Dr. Liu Qingyun said the results of this study show that in TB treatment, it is very important to develop treatment plan based on timely and accurate drug sensitivity results to improve cure rate and reduce drug resistance. (Source: Science Network Huang Xin)