阿克苏地区耐药结核杆菌基因分型及耐药性分析  

Genotyping and drug resistance analysis of drug-resistant Mycobacterium tuberculosis in Aksu Area

作　　者：刘丙雨 杨雪[1] 贾鹏霞 张万江[1] 程江[1,2] 吴江东[1] 马雅静[1,2] LIU Bing-yu;YANG Xue;JIA Peng-xia(Key Laboratory of Xinjiang Endemic and Ethnic Diseases Shihezi University;Department of Clinical Laboratory,the First Affiliated Hospital of Shiheri University School of Medicine,Shihezi Xinjiang 832000,China)

机构地区：[1]石河子大学新疆地方病与民族高发病教育部重点实验室 [2]石河子大学医学院第一附属医院,新疆石河子832000

出　　处：《微量元素与健康研究》2021年第3期53-56,共4页Studies of Trace Elements and Health

基　　金：NSFC-新疆联合基金资助项目(NO:U1803127);兵团重点领域科技攻关计划项目(NO:2018AB019)。

摘　　要：目的:初步了解新疆阿克苏地区耐药结核杆菌基因分型状况及影响耐多药产生的危险因素,为耐多药结核病防治提供有价值的信息。方法:收集阿克苏地区结核病专科医院(阿克苏第二人民医院)痰涂片阳性的维吾尔族肺结核病患者,从患者痰中分离并培养结核分枝杆菌并进行药物敏感试验,从186例临床分离株中筛选出65株耐药结核分枝杆菌,采用12个多位点数目可变串联重复序列(MIRU-VNTR)进行基因分型,同时应用logistic回归方法分析影响耐多药结核杆菌产生的危险因素。结果:65株耐药结核杆菌共产生52种基因型。其中独特基因型40种,余成12簇,每簇2~3株,共25株,成簇百分比38.5%(25/65),成簇率20%,耐多药成簇菌株12株,成簇百分比18.5%,成簇率11.5%。北京型耐多药菌株32株(61.5%),非北京型耐多药菌株20株(38.5%)。经单因素和多因素logistic分析显示,慢阻肺、复治、治疗中断或失败、肺空洞是MDR-TB产生的独立危险因素。结论:阿克苏地区耐药结核杆菌存在一定比例的近期传播,影响MDR-TB产生的危险因素有多种,需加强措施减少MDR-TB的产生和传播。Objective: In order to provide valuable information for the prevention and treatment of MDR-TB, the current situation of genotyping of MDR-TB and the risk factors of MDR-TB in Aksu area of Xinjiang were studied.Methods :From September 2018 to October 2019, Uighur tuberculosis patients with sputum smear positive in Aksu District tuberculosis hospital(Aksu Second People’s Hospital) were collected. Mycobacterium tuberculosis was isolated and cultured from the sputum of patients and drug sensitivity test was carried out. 65 strains of drug-resistant Mycobacterium tuberculosis were screened out from 186 clinical isolates, and 12 variable tandem repeats were used( MIRU-VNTR) and logistic regression were used to analyze the risk factors of producing MDR-TB. Results: 65 strains of drug-resistant Mycobacterium tuberculosis produced 52 genotypes. Among them, there are 40 unique genotypes, 12 clusters in total, 2~3 in each cluster, 25 in total, the clustering percentage is 38.5%(25/65), the clustering rate is 20%, 12 multi drug resistant clustering strains, the clustering percentage is 18.5%, the clustering rate is 11.5%. 32 strains(61.5%) were Beijing type and 20 strains(38.5%) were non Beijing type. Single factor and multi factor Logistic analysis showed that chronic obstructive pulmonary disease, retreatment, treatment interruption or failure, pulmonary cavity were independent risk factors for MDR-TB.Conclusion: There is a certain proportion of recent transmission of drug-resistant TB in Aksu area, and there are many risk factors affecting the production of MDR-TB. Measures should be strengthened to reduce the production and transmission of MDR-TB.

关 键 词：耐多药结核杆菌 基因分型 传播 危险因素 

分 类 号：R378.911[医药卫生—病原生物学]