2020—2021年凉山州4个彝族聚居县297株结核分枝杆菌耐药及菌株谱系分析  

Drug resistance and strain lineage of 297 strains of Mycobacterium tuberculosis in Yi ethnic area of Liangshan in Sichuan from 2020 to 2021

作　　者：张书[1] 雷卉 王为娜[1] 陈晓茹 王石金 王若冰 冯晓英 何金戈[1] 陈闯[1] ZHANG Shu;LEI Hui;WANG Weina;CHEN Xiaoru;WANG Shijin;WANG Ruobing;FENG Xiaoyin;HE Jinge;CHEN Chuang(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Liangshan Center for Disease Control and Prevention,Xichang 615000,Sichuan Province,China)

机构地区：[1]四川省疾病预防控制中心,成都610041 [2]凉山州疾病预防控制中心,四川西昌615000

出　　处：《预防医学情报杂志》2024年第12期1590-1598,共9页Journal of Preventive Medicine Information

摘　　要：目的对凉山州彝族聚居县培养获得的结核分枝杆菌进行全基因组测序并分析,了解该地区结核病耐药、耐药基因突变及流行菌株谱系情况,为该地区结核病防治工作开展提供科学参考。方法将凉山州昭觉县、越西县、美姑县、盐源县4个彝族聚居县2020—2021年分离培养获得的297株结核分枝杆菌通过高通量Illumina NovaSeq 6000二代测序平台进行全基因组测序,使用结核分枝杆菌全基因组序列分析平台SAM-TB分析其耐药情况、耐药突变、菌株谱系等,并使用SPSS 25.0软件对数据整理和进行统计学分析。率的比较采用χ^(2)检验,以P<0.05为差异有统计学意义。结果在297株结核分枝杆菌菌株中,未检出任何耐药基因的菌株数为234株,占78.79%;有任一耐药的菌株数为63株,总耐药率为21.21%;耐利福平率最高,为12.12%;耐异烟肼为9.09%,处第2位;单耐药率为15.49%;耐多药率为3.37%;准广泛耐药为1.68%;氯法齐明与贝达喹啉检出耐药基因突变,广泛耐药为0.67%。耐利福平以rpoB_S450L突变为主,耐异烟肼以katG_S315T突变为主。菌株谱系以L2最多,占66.67%,L4占31.31%,存在L2和L4、L4与L6混合样本。L2的耐药率高于L4(χ^(2)=4.742,P=0.029),差异有统计学意义,L2耐药风险是L4的2.079倍(95%CI:1.066~4.055)。结论本研究4个县结核病耐药较凉山州整体情况较轻,流行的结核分枝杆菌为L2和L4谱系菌株,以L2为主,患者存在多重感染,该地区应进一步加强结核病防治工作,减少结核分枝杆菌传播和耐药产生。Objective To sequence the whole genomes of 297 strains of Mycobacterium tuberculosis(MTB)isolated from areas in Yi Nationality Prefecture of Liangshan from 2020 to 2021,to understand the tuberculosis drug resistance,drug resistance gene mutations and epidemic strains lineages,and to provide scientific reference for tuberculosis prevention and control in this area.Methods A total of 297 strains of Mycobacterium tuberculosis isolated and cultured from Zhaojue County,Yuexi County,Meigu County and Yanyuan County in Liangshan Prefecture during 2020-2021 was sequenced by high-throughput Illumina NovaSeq 6000 next-generation sequencing platform.Drug resistance,resistance mutation,and strain lineage were analyzed using the whole genome sequence analysis platform SAM-TB,and the data were collated and statistically analyzed by using SPSS 25.0 software.Rates were compared using theχ^(2) test,and differences were considered statistically significant at P<0.05.Results The number of strains without any resistance genes was 234,accounting for 78.79%.The number of strains with any drug resistance was 63,and the total resistance rate was 21.21%.The resistance rate of rifampicin was the highest(12.12%),followed by isoniazid(9.09%).The mono-resistance rate was 15.49%,the multi-drug resistance rate was 3.37%,and the pre-extensively resistance was 1.68%.Resistance genes mutations for clofazimine and bedaquiline were detected,and the extensively resistance rate was 0.67%.Resistance genes mutations for rifampicin were dominated by rpoB_S450L,and for isoniazid is dominated by katG_S315T.The strain lineage was L2 with the most,accounting for 66.67%,followed by L4(31.31%),and there were mixed samples of L2 and L4,L4 and L6.The resistance rate of L2 was higher than that of L4(χ^(2)=4.742,P=0.029),and the risk of L2 resistance was 2.079 times that of L4(95%CI:1.066-4.055).Conclusions Tuberculosis drug resistance in this region is milder than in Liangshan,and the epidemic MTBs are L2 and L4 lineage strains,mainly L2,and patients have multi

关 键 词：结核分枝杆菌 凉山州 全基因组测序 耐药 菌株谱系 

分 类 号：R378.91[医药卫生—病原生物学]