Gesamtgenomsequenzierung der Tuberkulose View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-02

AUTHORS

V. Schleusener, M. Merker, T. A. Kohl, S. Niemann

ABSTRACT

Die Tuberkulose (TB) ist mit circa 10 Mio. Neuerkrankungen und 1,4 Mio. Todesfällen in 2015 eine der wichtigsten Infektionserkrankungen weltweit. Die TB-Bekämpfung wird durch das vermehrte Auftreten resistenter, multiresistenter (MDR) und extrem resistenter (XDR) Mycobacterium-tuberculosis-Komplex-(Mtbk‑)Stämme zunehmend erschwert. Für eine erfolgreiche Kontrolle und Therapie, insbesondere der resistenten TB, sind eine genaue Kenntnis der Epidemiologie und eine effektive Diagnostik essenziell. Hier haben in den letzten Jahren vermehrt Verfahren Anwendung gefunden, die das gesamte Erbgut („Whole Genome Sequencing“, WGS) klinischer Mtbk-Stämme mit sog. „Next-Generation-Sequencing“-(NGS-)Verfahren analysieren. WGS kann sowohl die Verwandtschaft von Stämmen, beispielsweise für eine Ausbruchsuntersuchung, bestimmen, als auch resistenzvermittelnde Veränderungen (z. B. Einzelbasenpaarunterschiede, „Single Nucleotide Polymorphisms“, SNPs) aus dem Genom der Erreger ermitteln. Die Genotypisierung (genetischer Fingerabdruck) von Mtbk-Stämmen mit klassischen oder genombasierten Verfahren hat sich als Standardmethode für molekularepidemiologische Studien etabliert. Klassische Anwendungen umfassen die Untersuchung von Laborkontaminationen, die Ermittlung von frischen Übertragungen in einer Population und die Erfassung von Ausbrüchen, wobei die Analyse der Übertragbarkeit und Ausbreitung von MDR/XDR-Stämmen von besonderer Bedeutung ist. Die Genomanalyse bietet darüber hinaus die Möglichkeit, resistenzvermittelnde Mutationen zuverlässig zu bestimmen und damit ein für den Patienten individualisiertes, molekularbiologisches Resistenzprofil zu erstellen. Für eine breite Anwendung der gesamtgenombasierten Verfahren müssen die bioinformatischen Analyseverfahren und die Interpretation der Ergebnisse allerdings noch deutlich vereinfacht und standardisiert werden. More... »

PAGES

35-42

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    http://scigraph.springernature.com/pub.10.1007/s10405-017-0156-4

    DOI

    http://dx.doi.org/10.1007/s10405-017-0156-4

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