河南省34株堪萨斯分枝杆菌分子分型及耐药性研究  

Molecular typing and drug resistance of 34 clinical isolates of Mycobacterium kansasii in He'nan Province

作　　者：王少华[1] 常文静 索文帅 苏茹月 郑丹薇 朱岩昆[1] 石洁[1] 马晓光[1] 孙定勇[1] 赵东阳[1] WANG Shaohua;CHANG Wenjing;SUO Wenshuai;SU Ruyue;ZHENG Danwei;ZHU Yankun;SHI Jie;MA Xiaoguang;SUN Dingyong;ZHAO Dongyang(Center for Disease Control and Prevention of He'nan Province,Zhengzhou,He'nan 450016,China)

机构地区：[1]河南省疾病预防控制中心,河南郑州450016

出　　处：《中国热带医学》2024年第10期1259-1264,共6页China Tropical Medicine

基　　金：河南省科技发展计划项目(No.192102310136),河南省医学科技攻关计划联合共建项目(No.LHGJ20220165)。

摘　　要：目的了解河南省堪萨斯分枝杆菌分离株分型及药物敏感性结果,为堪萨斯分枝杆菌病防治提供基础数据。方法收集河南省各地结核病定点医疗机构2019—2022年初步鉴定为非结核分枝杆菌的阳性培养物,进行菌种鉴定。以获得的34株堪萨斯分枝杆菌为研究对象,采用微孔板法检测11种药物的敏感性,并用PCR-限制性内切酶谱方法进行分型。结果34株堪萨斯分枝杆菌对阿米卡星、利奈唑胺和利福布汀3种药物为全敏感;阿米卡星、利奈唑胺和利福布汀的MIC_(50)和MIC_(90)分别为2 mg/L和4 mg/L,1 mg/L和1 mg/L,0.25 mg/L和0.25 mg/L。堪萨斯分枝杆菌对克拉霉素、利福平、米诺环素、莫西沙星和甲氧苄啶/磺胺甲恶唑的耐药率分别为2.94%、8.82%、2.94%、5.88%和11.76%;克拉霉素、利福平、米诺环素、莫西沙星和甲氧苄啶/磺胺甲恶唑MIC_(50)和MIC_(90)分别为1 mg/L和1 mg/L,0.5 mg/L和1 mg/L,1 mg/L和2 mg/L,0.25 mg/L和0.25 mg/L,0.25/4.75 mg/L和8/152 mg/L。堪萨斯分枝杆菌对多西环素、乙胺丁醇和环丙沙星的耐药率比较高,分别为94.12%、50.00%和44.12%。34株堪萨斯分枝杆菌对11种抗生素均有不同程度的耐药,同时耐2种以上药物者共有25株(73.53%),耐4种以上药物者共有4株(11.76%)。经PCR-限制性内切酶谱分析34株堪萨斯分枝杆菌都属于亚型Ⅰ。结论克拉霉素、利福平、阿米卡星、利奈唑胺、米诺环素、莫西沙星、利福布汀和甲氧苄啶/磺胺甲恶唑等药物在体外对河南省分离的堪萨斯分枝杆菌临床株具有较好的抗菌活性。河南省临床分离堪萨斯分枝杆菌主要由亚型Ⅰ组成。Objective To understand the typing and drug sensitivity results of M.kansasii strains in He'nan Province,and to provide basic data for the prevention and treatment of M.kansasii infections.Methods Positive cultures preliminarily identified as nontuberculous mycobacteria from designated tuberculosis medical institutions across He'nan Province from 2019 to 2022 were collected for strain identification.The minimum inhibitory concentration(MIC)of 11 drugs of 34 clinical isolates of M.kansasii was determined by the microdilution method.PCR-restriction enzyme pattern analysis was used for typing.Results As a result,34 clinical isolates of M.kansasii were totally sensitive to three drugs:amikacin,linezolid,and rifampicin.The MIC_(50) and MIC_(90) of amikacin,linezolid,and rifampicin were 2 mg/L and 4 mg/L,1 mg/L and 1 mg/L,and 0.25 mg/L and 0.25 mg/L,respectively.The resistance rates to clarithromycin,rifampicin,minocycline,moxifloxacin,and trimethoprim/sulfamethoxazole were 2.94%,8.82%,2.94%,5.88%,and 11.76%,respectively.The MIC_(50) and MIC_(90) of clarithromycin,rifampicin,minocycline,moxifloxacin,and trimethoprim/sulfamethoxazole were 1 mg/L and 1 mg/L,0.5 mg/L and 1 mg/L,1 mg/L and 2 mg/L,0.25 mg/L and 0.25 mg/L,as well as 0.25/4.75 mg/L and 8/152 mg/L,respectively.The clinical isolates of M.kansasii showed relatively high resistance rates to doxycycline,ethambutol,and ciprofloxacin,with resistance rates of 94.12%,50.00%,and 44.12%,respectively.Thirty-four strains of M.kansasii showed varying degrees of resistance to 11 antibiotics,while there were a total of 25 strains(73.53%)resistant to more than two drugs and a total of 4 strains(11.76%)resistant to more than four drugs.According to PCR-restriction enzyme pattern analysis,34 strains of M.kansasii belong to subtype I.Conclusions Clarithromycin,rifampicin,amikacin,linezolid,minocycline,moxifloxacin,rifampicin,and trimethoprim/sulfamethoxazole have good in vitro antibacterial activity against clinical strains of M.kansasii isolated from He'nan Province mainly cons

关 键 词：堪萨斯分枝杆菌 耐药 基因型 PCR-限制性内切酶谱分析 

分 类 号：R378.91[医药卫生—病原生物学]