论文部分内容阅读
目的探讨四川德阳地区结核分枝杆菌耐药基因突变位点的分布特点及基因型耐药的分析。方法收集在2010年2月-2013年3月检出的257例肺结核病患者结核分枝杆菌DNA阳性的痰液标本,采用聚合酶链式反应(PCR)和反向点杂交(RDB)相结合的基因芯片技术对结核分枝杆菌耐药基因突变位点进行检测和分析。结果 257例肺结核患者中检测出49例存在结核分枝杆菌耐药基因位点突变,其中发生katG 315、rpsL43、embB 306和rpoB 531丝氨酸(S531L)位点突变的分别为30例(11.67%)、18例(7.00%)、11例(4.28%)和10例(3.89%)。234例初治肺结核患者对异烟肼、利福平、乙胺丁醇及链霉素的基因型耐药率分别为9.83%、4.27%、3.42%和5.13%,耐多药率为2.99%;23例复治肺结核患者对上述药物的基因型耐药率分别为52.17%、26.09%、13.04%和43.48%,耐多药率为13.04%。初治患者的基因型耐药率及耐多药率均明显低于复治患者。结论四川德阳地区结核分枝杆菌常见耐药基因突变位点分别为katG 315、rpsL 43、embB 306和rpoB 531丝氨酸(S531L)突变位点;肺结核初治患者的基因型耐药率及耐多药率均明显低于复治患者;该地区肺结核的耐多药率相对较低。
Objective To investigate the distribution and genotypic resistance of Mycobacterium tuberculosis (MDR) gene mutations in Deyang, Sichuan Province. Methods Totally 257 sputum samples of M. tuberculosis DNA positive sputum collected from February 2010 to March 2013 were collected by polymerase chain reaction (PCR) and reverse dot blot (RDB) Gene chip technology to detect and analyze the mutation sites of Mycobacterium tuberculosis resistance gene. Results A total of 49 cases were detected in 257 pulmonary tuberculosis patients. The mutation of serine (S531L) in katG 315, rpsL43, embB 306 and rpoB 531 occurred in 30 cases (11.67%), , 18 cases (7.00%), 11 cases (4.28%) and 10 cases (3.89%). The resistance rates of genotypes of isoniazid, rifampicin, ethambutol and streptomycin were 234%, 4.27%, 3.42% and 5.13% in 234 newly diagnosed tuberculosis patients, respectively, and the multidrug resistance rate was 2.99% ; 23 cases of re-treatment of tuberculosis patients were 52.17%, 26.09%, 13.04% and 43.48% of the drug-resistant genotypes respectively, and the multidrug resistance rate was 13.04%. The newly diagnosed patients with genotype resistance and MDR rates were significantly lower than the retreatment patients. Conclusions Mutations of common resistance genes of Mycobacterium tuberculosis in Deyang area of Sichuan Province are katG 315, rpsL 43, embB 306 and rpoB 531 serine (S531L) mutation sites respectively. Genotype resistance and MDR in patients with newly diagnosed pulmonary tuberculosis The rates were significantly lower than that of retreatment patients; the rate of multidrug-resistant pulmonary tuberculosis in this area was relatively low.