摘要
目的分析新乡地区结核分枝杆菌利福平耐药株基因型,为控制耐药性发展与耐药株传播奠定基础。方法收集患者痰液样本370例,鉴定结核分枝杆菌。对菌株进行耐药性分析及rpoB基因扩增及测序,分析耐药株基因型。结果370例新乡地区患者中分离174株结核分枝杆菌,分离率为47.03%。其中,2016-2018年各分离结核分枝杆菌29、63和82株,分离率为36.25%、45.32%和54.30%。2016年29株结核分枝杆菌对利福平、异烟肼、链霉素、氧氟沙星的耐药率分别为48.28%、44.83%、34.48%和27.59%;2017年63株结核分枝杆菌耐药率分别为61.90%、47.62%、38.10%、26.98%;2018年82株结核分枝杆菌耐药率分别为70.73%、57.32%、39.02%和35.37%。111株利福平耐药的结核分枝杆菌中,87株发生rpoB基因变异,基因突变率为78.38%。其中Ser→Leu在521位点突变58株(52.25%)和His→Leu在526位点突变22株(19.82%)是主要基因突变类型。此外,有24株(21.62%)未发生变异。结论2016-2018年新乡地区患者结核分枝杆菌分离率逐年增高。结核分枝杆菌对利福平耐药率最高,且逐年增高。利福平耐药株的耐药性产生的主要机制是rpoB基因发生位点突变。
Objectives Genotype study on rifampin-resistant strains of Mycobacterium tuberculosis in Xinxiang area was analyzed to lay a foundation for controlling the development of drug resistance and the spread of drug-resistant strains.Methods The sputum samples of 370 patients were collected to identify M.tuberculosis.Drug resistance analysis and rpoB gene amplification and sequencing were carried out to analyze the rpoB genotype of drug-resistant strains.Results 174 strains of M.tuberculosis were isolated from 370 patients in Xinxiang district,and the isolation rate was 47.03%.Among them,there were 29 strains,63 strains and 82 strains of M.tuberculosis isolated from 2016 to 2018,with the isolation rates of 36.25%,45.32%and 54.30%.In 2016,the drug resistance rates of 29 strains of M.tuberculosis to rifampicin,isoniazid,streptomycin and ofloxacin were 48.28%,44.83%,34.48%and 27.59%,respectively.In 2017,the resistance rates of 63 strains of M.tuberculosis to rifampicin,isoniazid,streptomycin and ofloxacin were 61.90%,47.62%,38.10%and 26.98%,respectively.In 2018,the resistance rates of 82 strains of M.tuberculosis to rifampicin,isoniazid,streptomycin and ofloxacin were 70.73%,57.32%,39.02%and 35.37%,respectively.PCR amplification and sequencing showed that among 111 strains of rifampicin-resistant M.tuberculosis,there 87 strains had rpoB gene variation,with a mutation rate of 78.38%.There were 58 strains(52.25%)with Ser→Leu mutation at site 521 and 22 strains(19.82%)with His→Leu mutation at site 526,which were the main mutation types.In addition,24 strains(21.62%)did not mutate.Conclusion From 2016 to 2018,the isolation rate of M.tuberculosis increased year by year in Xinxiang area.M.tuberculosis had the highest drug resistance rate to rifampin,and the drug resistance rate increased year by year.RpoB gene mutation may be responsible for the development of drug resistance in rifampicin resistant strains.
作者
万勇敢
牛文一
李明瑛
WAN Yong-gan;NIU Wen-y;LI Ming-ying(The First Aff iliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan,China)
出处
《中国病原生物学杂志》
CSCD
北大核心
2019年第11期1328-1331,共4页
Journal of Pathogen Biology
关键词
新乡地区
结核分枝杆菌
利福平
耐药株基因型
Xinxiang area
Mycobacterium tuberculosis
rifampin
drug-resistant strains genotype
作者简介
通讯作者:万勇敢(1981-),男,河南安阳人,本科,主治医师。主要从事结核病诊疗工作。E-mail:p328474@163.com。
