结核分枝杆菌基因分型与耐药性及分子流行特征探讨  

Genotyping, drug resistance and molecular epidemic characteristics of Mycobacterium tuberculosis

作　　者：葛君 陈赟 傅妤倩 薄旭芬 陈兆军[2] GE Jun;CHEN Yun;FU Yu-qian(Department of Pharmacy,Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310004,China)

机构地区：[1]杭州师范大学附属医院药剂科,浙江杭州310004 [2]杭州市第二人民医院药剂科,浙江杭州310000

出　　处：《中华全科医学》2019年第11期1938-1940,共3页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2014ZDA018)

摘　　要：目的结核分枝杆菌是临床上罕见的疾病,常见类型较多,且随着临床抗结核药物的大量、不合理使用,导致结核分歧杆菌耐药性较高。因此,本文主要探讨结核分枝杆菌基因分型与耐药性及分子流行特征。方法选择2018年1月-2018年12月杭州师范大学附属医院胸外科测定的结核分枝杆菌391株作为对象,所有病原菌均采用寡核苷酸分型(spoligotyping)法完成基因的分型;选择一线抗结核药物利福平(RFP)、乙胺丁醇(EMB)、异烟肼(INF)及链霉素(SM)药物进行药敏试验。结果391株结核分枝杆菌均完成基因分型,其中北京家族结核分枝杆菌339株,占86.70%;非北京家族结核分枝杆菌52株,占13.30%;Spoligotyping测定结果表明:北京家族菌分子流行病学仅与35~43之间的9个间隔区呈阳性;而其余结核分枝杆菌集中在35~43间1~5个位点呈阴性反应;391株结核分枝杆菌基因分型排在前3位的分别为北京型、T1型与新发现基因型,分别占86.70%、5.12%和3.58%;391株结核分枝杆菌均完成耐药性分析,北京型结核分枝杆菌与非北京型结合分枝杆菌对于RFP、EMB、INF及SM耐药性比较差异均无统计学意义(均P>0.05)。结论结核分枝杆菌基因呈多态性,而分子流行病学特点以北京家族为主,且与耐药性无明显的相关性。Objective To investigate the genotyping,drug resistance and molecular characteristics of Mycobacterium tuberculosis.Methods A total of 391 Mycobacterium tuberculosis strains were selected from department of thoracic surgery from January to December 2018,and genotyped by spoligotyping method.First-line anti-tuberculosis drugs rifampicin(RFP),ethambutol(EMB),isoniazid(INF)and streptomycin(SM)were used for drug sensitive testing.Results The results of genotyping showed that the Beijing family strains were 339 strains(86.70%),the non-Beijing family were 52 strains(13.30%).Spoligotyping showed that the molecular epidemiology of Beijing family bacteria was only positive with 9 compartments between 35 and 43,while the remaining strains was negative in 1-5 sites between 35 and 43.The 391 strains were genotype ranked in the top three:Beijing type,T1 type and newly type,accounting for 86.70%,5.12%,and 3.58%,respectively.There was no significant difference in the resistance of Beijing-type Mycobacterium tuberculosis to non-Beijing-type mycobacteria for RFP,EMB,INF and SM(all P>0.05).Conclusion The Mycobacterium tuberculosis gene is polymorphic,while the molecular epidemiology characteristics are mainly in the Beijing family and have no significant correlation with drug resistance.

关 键 词：结核分枝杆菌 基因分型 耐药性 分子流行特征 实时荧光定量 

分 类 号：R378.911[医药卫生—病原生物学] R394.3[医药卫生—基础医学]