耐多药结核分枝杆菌对环丝氨酸、对氨基水杨酸的耐药性及其与基因型关系分析  

Analyses on resistance to cycloserine and p-aminosalicylic acid and genotypes in multidrug-resistant M. tuberculosis isolates

作　　者：杨健 逄宇[3] 赵雁林[3] 张天华 王西娣 陈美龄 李妍 王蕊 

机构地区：[1]陕西省结核病防治研究所结核病参比实验室,西安710048 [2]陕西省结核病防治研究所办公室,西安710048 [3]中国疾病预防控制中心结核病预防控制中心

出　　处：《中国防痨杂志》2015年第2期122-127,共6页Chinese Journal of Antituberculosis

摘　　要：目的 评价耐多药结核分枝杆菌菌株对环丝氨酸（Cs）和对氨基水杨酸（PAS）两种二线抗结核药物的耐药性并分析耐药表型与基因型之间的关联，为我国耐多药结核病的治疗提供科学依据。 方法 从2007年全国耐药基线调查点收集的菌株中选取196株耐多药结核分枝杆菌菌株，采用微孔板Alamar blue显色法分别测定对Cs和PAS的最低抑菌浓度（MIC），并采用间隔区寡核苷酸分型法（Spoligotyping）对其进行基因分型。北京基因型与非北京基因型对Cs和PAS耐药率比较采用卡方检验，以P〈0.05为差异有统计学意义。结果196株耐多药结核分枝杆菌菌株中对Cs耐药为44株，耐药率为22.4%（44/196）；对PAS耐药为34株，耐药率为17.3%（34/196）。在耐Cs的耐多药结核分枝杆菌菌株中北京基因型为34株，耐药率为21.0%（34/162）；34株非北京基因型菌株中耐Cs为10株，耐药率为29.4%（10/34）；两者耐药率差异无统计学意义（χ^2=1.15，P〉0.05）。在耐PAS的耐多药结核分枝杆菌菌株中北京基因型为26株，耐药率为16.0%（26/162）；34株非北京基因型菌株中耐PAS为8株，耐药率为23.5%（8/34）；两者耐药率差异无统计学意义（χ^2=1.10，P〉0.05）。 结论 我国耐多药结核分枝杆菌对二线抗结核药物Cs和PAS的耐药率处于较高水平。北京基因型家族是我国耐多药结核分枝杆菌中主要流行的菌株，北京基因型与非北京基因型的耐多药结核分枝杆菌菌株对Cs和PAS两种二线抗结核药物耐药率差异无统计学意义。Objective To evaluate the resistance to cycloserine （Cs） and p-aminosalicylic acid （PAS） in multi-drug resistant （MDR） M. tuberculosis isolates, and analyze the relationship between the genotype and drug-resistant phenotype, which will provide the scientific evidence for MDR-tuberculosis treatment. Methods One hundred and ninety-six MDR-M.tuberculosis isolates were collected from the first tuberculosis drug resistance survey of China conducted in 2007, were detected their minimum inhibition concentrations （MICs） of Cs and PAS by microplate Alamar blue assay, and were analyzed the genotypes by Spoligotyping method. Cs and PAS resistant rates between Beijing genotype and non-Beijing genotype strains were compared using Chi square test, P〈0.05 was considered as statistically significant difference. Results Of 196 MDR-M. tuberculosis isolates, 22.4%（44/196） were resistant to Cs, and 17.3%（34/196） were resistant to PAS. 82.7%（162/196）isolates belonged to Beijng geno-type, while 17.3%（34/196） strains belonged to non-Beijing genotypes. Of 162 Beijing genotype strains, 21.0% （34/162）strains were resistant to Cs, while 29.4%（10/34） of non-Beijing genotype strains were resistant to Cs. There were no statistical difference in Cs-resistant rates between Beijing and non-Beijing genotype strains（χ^2=1.15,P〉0.05）. 16.0%（26/162）of Beijing genotype strains were resistant to PAS, while 23.5% （8/34） of non-Beijing genotype strains showed the resistance to PAS. They had no significant difference（χ^2=1.10,P〉0.05）. Conclusion The Cs- and PAS-resistant rates in MDR-M. tuberculosis strains were high in China. Beijing genotype was the predominant among MDR-M. tuberculosis isolates in China. The Cs- and PAS-resistant rates between Beijing and non-Beijing genotype strains had no significant difference.

关 键 词：结核分枝杆菌 抗药性 多种 细菌 环丝氨酸 氨基水杨酸 基因型 

分 类 号：R52[医药卫生—内科学]