安徽东部地区结核分枝杆菌基因分型及耐药情况的初步分析  

A primary analysis of the drug resistance and genotyping of the Mycobacterium tuberculosis in the eastern area of Anhui Province

作　　者：朱明 程险峰 文育锋[2] 贡秀云 张书金 杨卉 洪颖 詹圣伟 

机构地区：[1]安徽省马鞍山市疾病预防与控制中心检验科,安徽马鞍山243000 [2]皖南医学院公共卫生学院预防医学教研室,安徽芜湖241001

出　　处：《中华疾病控制杂志》2015年第5期477-480,共4页Chinese Journal of Disease Control & Prevention

摘　　要：目的了解安徽东部地区结核分枝杆菌基因分型及耐药情况,为本地区肺结核的防治提供依据。方法对从临床收集的80例结核菌株进行培养,分别通过可变数目串联重复序列分型技术、药敏实验对菌株进行分型、耐药情况分析。结果单耐药菌株占25.00%,多耐药菌株占23.75%。单耐药菌株以利福平和对氨基水杨酸占多数,分别为28.75%和22.50%;多耐药菌株以对异烟肼和利福平耐药最多,占52.63%。初治病人和复治病人对吡嗪酰胺耐药差异有统计学意义(P=0.032),对其他药物的耐药差异均无统计学意义(均有P>0.05)。15个基因位点均呈现等位基因多态性,QUB11a位点多态性最高为0.85,Mtub31位点仅为0.11。80株菌株可分为33个基因型,仅有16例患者的分离株为单一基因型,其余菌株可归入14个簇。结论本地区结核分支杆菌的耐药率较高,基因分型复杂。Objective To understand the drug resistance of Mycobacterium tuberculosis and its distribution of the genotypes in the eastern area of Anhui province, and to provide strategies for the prevention and treatment of tuberculosis. Methods Eighty cases of mycobacterium tuberculosis were collected from clinical isolates. The genotypes and drug resistances of Mycobacterium tuberculosis were analyzed through variable number tandem repeats and drug sensitivity test respectively. Restflts All of the isolates were Mycobacterium tuberculosis, and 25.00% of them were single drug resistance and 23.75% were multi-drug resistant strains. The percentages of the drug resistance to rifampicin and para amino salicylate were 28.75% and 22. 50%, respectively. Resistant to isoniazid and rifampicin were the main multi-drug resistance accounting for 52. 63%. There was significant difference in resistance to pyrazinamide between the first treatment and multitreatment patients（ P = 0. 032 ）. All of the 15 loci showed polymorphic alleles, among them QUB11 a site polymorphism was up to 0. 85, Mtub31 site only was 0. 11. Eighty strains were divided into 33 genotypes, only 16 isolates belonged to one genotype, the others were classified as 14 clusters. Conclusions The drug resistance of Mycobacterium tuberculosis is high and genotype distribution is complex.

关 键 词：分枝杆菌 结核 广泛耐药结核 基因型 

分 类 号：R378.911[医药卫生—病原生物学] R181.2[医药卫生—基础医学]