豫北地区结核分枝杆菌临床分离株基因型及四种二线药物耐药性分布的分析  

Analysis of clinical isolates genotypes of Mycobacterium tuberculosis and distribution of drug resistance to four second-line drugs in Northern Henan Province

作　　者：朱增红 张会强 屠永凯 叶鹏 赵顺现 宋庆芳 王红民[6] ZHU Zeng-hong;ZHANG Hui-qiang;TU Yong-kai;YE Peng;ZHAO Shun-xian;SONG Qing-fang;WANG Hong-min(the Sixth Department of Infection,the Third People’s Hospital of Jiaozuo,Jiaozuo,Henan 454172,China;Department of Tuberculosis,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang,Henan 453100,China;Anyang Tuberculosis Prevention and Control Institute,Anyang,Henan 455000,China;Tuberculosis Department of Hebi Infectious Disease Hospital,Hebi,Henan 458000,China;Puyang Fifth People’s Hospital,Henan 457001,China;Department of Respiratory Medicine,Zhengdong Hospital,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)

机构地区：[1]焦作市第三人民医院感染六科,河南焦作454172 [2]新乡医学院第一附属医院结核三科,河南新乡453100 [3]安阳市结核病防治所,河南安阳455000 [4]鹤壁市传染病医院结核科,河南鹤壁458000 [5]濮阳市第五人民医院,河南濮阳457001 [6]郑州大学第一附属医院郑东院区呼吸内三科,河南郑州450052

出　　处：《临床肺科杂志》2022年第4期595-597,639,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨豫北地区结核分枝杆菌临床分离株基因型及四种二线药物耐药性分布。方法纳入豫北地区2019年收治肺结核痰涂片阳性培养标本中,结核分枝杆菌(MTB)菌株共2280株,均行MTB基因型鉴定和药敏试验检查,分析纳入患者一般资料和风险因素,评价MTB基因型与再次抗结核治疗耐药性间相关性。结果2280株MTB菌株中北京和非北京型MTB菌株分别为1882株,398株;北京和非北京型MTB中性别、≥65岁比例及户籍情况比较,差异有统计学意义(P<0.05);北京和非北京型MTB菌株中无耐药和耐多药比例比较,差异无统计学意义(P>0.05);北京型MTB菌株耐左氧氟沙星、耐阿米卡星、耐卷曲霉素及耐对氨基水杨酸比例均显著低于非北京型MTB菌株(P<0.05)。结论豫北地区MTB菌株以北京型为主,且男性和非本市户籍人口更为常见;同时非北京型菌株更易出现左氧氟沙星、阿米卡星、卷曲霉素及对氨基水杨酸耐药。Objective To investigate the clinical isolates genotypes of Mycobacterium tuberculosis and distribution of drug resistance to four second-line drugs in Northern Henan province.Methods 2280 strains of MTB were collected from sputum smear positive culture specimens of tuberculosis in Northern Henan in 2019,and the total MTB genotypes were identified and they were given drug sensitivity test.The general data and risk factors were analyzed and the relationship between MTB genotypes and drug resistance of anti-tuberculosis therapy were evaluated.Results 2280 strains of MTB included 1882 strains with Beijing genotype and 398 strains with non-Beijing genotype.There were significant differences between Beijing and non-Beijing genotypes in terms of gender,proportion of over 65 years old and household registration(P<0.05).There was no significant difference in the proportion of non drug resistance and multi drug resistance between Beijing and non Beijing genotype MTB strains(P>0.05).The resistance proportions of levofloxacin,amikacin,capreomycin and p-aminosalicylic acid of Beijing genotype MTB strains were significantly lower than non-Beijing genotype MTB strains(P<0.05).Conclusion Beijing genotype is the main type of MTB strains in Northern Henan,and male and non local residents are more common.Non-Beijing genotypes are more susceptible to levofloxacin,amikacin,capreomycin and aminosalicylic acid resistance.

关 键 词：MTB 基因型 抗结核治疗 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R96[医药卫生—临床医学]