16例皮肤结核分离菌株药敏试验分析  

Drug susceptibility test for 16 Mycobacteria tuberculosis isolates from patients with cutaneous tuberculosis

作　　者：张彩萍[1] 季江[2] 林麟[1] 杨毅琴[3] 崔盘根[1] 冯雨苗[1] 岳晓玉[1] 赵亮[1] 曾学思[1] 吴勤学[1] 王洪生[1] 

机构地区：[1]中国医学科学院北京协和医学院皮肤病研究所,南京210042 [2]苏州大学附属第二医院皮肤科 [3]南京市胸科医院结核病研究室

出　　处：《中华皮肤科杂志》2009年第6期371-373,共3页Chinese Journal of Dermatology

摘　　要：目的探讨结核分枝杆菌皮肤感染的耐药情况，为该病的临床治疗提供参考依据。方法分离培养的16株分枝杆菌经生化和分子生物学方法鉴定为结核分枝杆菌；采用国内公认的绝对浓度间接法分别检测16株结核分枝杆菌对异烟肼、链霉素、利福平和乙胺丁醇四种药物的耐药情况；对其中2株链霉素耐药临床株进行rpsL基因扩增和DNA测序。结果16株结核分枝杆菌中，2株对链霉素耐药，对异烟肼、利福平和乙胺丁醇敏感；其余14株对利福平、异烟肼、乙胺丁醇和链霉素均敏感。2株链霉素耐药临床株中，1株rpsL基因43位密码子突变为AAG→AGG；另一株rpsL基因54位密码子突变为CGC→CAC。结论近5年收治的结核分枝杆菌皮肤感染患者耐药率不高，以链霉素耐药为主。Objective To test the drug susceptibility of 16 Mycobacteria tuberculosis isolates from patients with cutaneous tuberculosis, and to provide a basis for the treatment of this entity. Methods Sixteen strains of mycobacterium were isolated from patients with cutaneous tuberculosis, and they were consistently identified as M. tuberculosis by biochemistry and molecular biology. Absolute concentration method was used to test the susceptibility of these isolates to isoniazid, streptomycin, rifampicin and ethambutol. For two strains resistant to streptomycin, PCR and sequencing were performed to analyse the mutation of rpsL gene. Results Out of the 16 strains of M. tuberculosis, 2 were resistant to streptomycin but sensitive to isoniazid, rifampicin and ethambutol, and 14 were sensitive to isoniazid, streptomycin, rifampicin and ethambutol. Sequencing of the rpsL gene revealed a mutation of AAG to AGG at codon 43 in one streptomycinresistant strain and a substitution of CGC by CAC at codon 54 in another resistant strain. Conclusions In past five years, the resistance ratio of M. tuberculosis was low in patients with cutaneous tuberculosis, and streptomycin resistance predominated in these strains.

关 键 词：分枝杆菌 结核 抗药性 链霉素抗药性 基因 rpsL 

分 类 号：R446.5[医药卫生—诊断学] R529.4[医药卫生—临床医学]