遂宁市1501株结核分枝杆菌分离株基因芯片耐药检测结果分析  

Analysis on the results of gene chip drug resistance detection of 1501 strains of mycobacterium tuberculosis isolates in Suining City

作　　者：米静 贺泽刚 宋耀芳 袁菁[1] 郭航 张书[2] MI Jing;HE Zegang;SONG Yaofang;YUAN Jing;GUO Hang;ZHANG Shu(Suining Center for Disease Control and Prevention,Suining 629000,Sichuan Province,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)

机构地区：[1]遂宁市疾病预防控制中心,四川遂宁629000 [2]四川省疾病预防控制中心,成都610041

出　　处：《预防医学情报杂志》2023年第9期1114-1118,共5页Journal of Preventive Medicine Information

摘　　要：目的 了解遂宁市结核分枝杆菌利福平和异烟肼耐药及相关耐药基因突变情况,为结核病防治工作开展提供参考依据。方法 对遂宁市2019年1月至2022年4月收到的1 558例结核病患者痰样本罗氏固体培养基分离得到的菌株利用基因芯片技术进行菌种鉴定,对鉴定为结核分枝杆菌复合群(MTBC)的菌株,使用耐药基因芯片进行利福平(RFP)和异烟肼(INH)耐药检测,分析耐药情况。结果 1 558株临床分离菌株检出MTBC菌株1 501株(96.34%);126株MTBC菌株存在rpoB突变,其中94.44%为单一位点突变,最高突变率发生在rpoB基因531位点(66/126,52.38%);170株MTBC菌株存在katG/inhA突变株,katG单一位点突变为79.41%,inhA单一位点突变为18.82%,最高突变率发生在katG基因315位点(135/170,79.41%)。至少对RFP和INH中的一种药物耐药219株,占14.59%(219/1 501),其中RFP耐药率为8.39%(126/1 501),异烟肼耐药率为11.33%(170/1 501),耐多药率5.13%(77/1 501)。耐多药高危和非高危人群中肺结核病患者利福平耐药率分别为17.37%、7.09%(χ^(2)=22.78,P<0.001),异烟肼耐药率分别为19.47%、10.14%(χ^(2)=14.38,P<0.001),耐多药率分别为9.47%、4.5%(χ^(2)=8.43,P=0.004),差异均有统计学意义。结论 遂宁市结核病患者结核分枝杆菌耐多药、耐利福平、耐异烟肼耐药率都处于较高水平,利福平耐药突变主要发生在rpoB基因531位,异烟肼耐药突变主要发生在katG基因315位,基因芯片法可以快速鉴定结核分枝杆菌复合群并进行耐药检测,具有较高的临床应用价值。Objective To understand the rifampicin and isoniazid resistance of mycobacterium tuberculosis and the mutation of related drug resistance genes in Suining City,so as to provide reference for the prevention and treatment of tuberculosis.Methods From January 2019 to April2022,total of 1558 strains isolated from tuberculosis patients in Roche solid culture medium were first identified by gene chip technology,and then the strains identified as mycobacterium tuberculosis complex(MTBC)were detected for rifampicin(RFP)and isoniazid(INH)resistance by drug resistance gene chip,and drug resistance was analyzed.Results Among 1558 strains,1501 MTBC strains were detected,accounting for 96.34%;A total of 126 MTBC strains had rpoB mutations,among them 94.44%of which were single site mutations,and the highest mutation rate of RFP occurred at rpoB gene 531 site(66/126,52.38%);170 MTBC strains were detected with katG/inhA mutation.The single mutation of katG was 79.41%,and the single mutation of inhA was18.82%.The highest mutation rate of isoniazid occurred at the 315 site of katG gene(135/170,79.41%).About 219 strains were resistant to at least one of the drug in RFP and INH,accounting for 14.59%(219/1501),of which the resistance rate in RFP was 8.39%(126/1501),the resistance rate in isoniazid was 11.33%(170/1501),and the multi drug resistance rate was 5.13%(77/1501).The rifampicin resistance rate of pulmonary tuberculosis patients in high-risk and non high-risk groups of multi drug resistance was 17.37%and 7.09%,respectively(χ^(2)=22.78,P0.001),the isoniazid resistance rate was 19.47%and 10.14%,respectively(χ^(2)=14.38,P0.001),and the multi drug resistance rate was 9.47%and 4.5%,respectively(χ^(2)=8.43,P=0.004).The differences were statistically significant.Conclusions The multidrug resistance,rifampicin resistance and isoniazid resistance rates of mycobacterium tuberculosis patients in Suining City are all at a high level.Rifampicin resistance mutations mainly occur at position 531 of the rpoB gene,and isoniazid resistance m

关 键 词：结核病 结核分枝杆菌 基因芯片法 耐药 

分 类 号：R521[医药卫生—内科学]