多重耐药结核临床分离株耐药性和北京基因型相关性分析  

Drug-resistance distribution on tuberculosis strains and research of correlation between multidrug-resistance phenotypes of mycobacterium tuberculosis and Beijing genotypes strains

作　　者：雷飏[1] 刘爱平[1] 侯僖硕[1] 朱平德 

机构地区：[1]湖南省郴州市疾病预防控制中心,湖南郴州423000 [2]湖南省桂阳县疾病预防控制中心

出　　处：《现代预防医学》2013年第3期528-530,共3页Modern Preventive Medicine

基　　金：湖南省科技计划项目(2012FJ3064)

摘　　要：目的初步分析探讨多重耐药结核分枝杆菌(multiple drugs resistant bacillus tuberculosis,MDR-MTB)和北京型的相关性。方法从涂阳病人痰液中分离结核分枝杆菌,用固体培养基比例法对其进行一线和二线抗结核药物敏感性试验,筛选出耐多药菌株,对上述多重耐药菌株及随机抽取的20株全敏株进行间隔寡核苷酸分型(Spoligotyping)检测,采用χ2检验进行统计学分析。结果从154例涂阳病人痰液中分离得到138株结核分枝杆菌,RFP、INH、SM、EMB、OFX、AMK、KM、CPM的耐药率分别为49.28%(68/138),58.70%(81/138),44.93%(62/138),28.99%(40/138),57.25%(79/138),17.39%(24/138),13.04%(18/138),21.01%(29/138),一线药和二线药全耐率分别20.29%(28/138)和4.35%(6/138),MDR-MTB占43(31.16%)株。39株北京型中MDR-MTB为33株(84.62%),全敏株为6株(15.38%),MDR发生率高于非北京型菌株经检验具有统计学意义(χ2=12.64,P﹤0.05)。结论本研究分离得到的MDR-MTB的耐药性和北京基因型有一定的相关性。OBJECTIVE To investigate the correlation between multidrug-resistance phenotypes of mycobacterium tuberculosis and Beijing genotypes. METHODS Clinical strains were collected from 154 sputum- positive patients and used for drug-sensi- tive test by L-J solid medium, and selected multidrug-resistance myeobacterium tuberculosis （MDR-MTB）. Identified the genotypes of MDR-MTB by Spoligotyping assay. The statistical analysis was performed with χ2 test. RESULTS Among the 154 samples, 138 strains were identified as MTB. And the dug-resistance test showed that the drug resistance rates were RFP （49.28%）, INH （8.70%）, SM （44.93%）, EMB （28.99%）, OF）（（57.25%）, AMK （17.39%）, KM （13.04%） and CPM （21.01%） respectively. There were also 20.29% MTB samples resistant to all first-line anti-TB drugs and 4.35% to all second- line drugs. Besides, 43 strains （31.16%） were identified as MDR-MTB. The Spoligotyping assay results showed that there were a number of 33 （84.62%） MDR-MTB strains and only 6 （15.38%） drug-sensitive strains among the total 39 Beijing family strains. The statistical analysis revealed that χ2 = 12.64, P 〈 0.05. CONCLUSION These results indicate that the drug-resis- tance phenotypes of MDR-MTB may be related to Beijing genotypes, therefore, we should do more research on M. tuberculosis strains associated with the Beijing family.

关 键 词：多重耐药结核分枝杆菌 北京基因型 间隔寡核苷酸分型 

分 类 号：R378.911[医药卫生—病原生物学]