172株结核分枝杆菌耐药性分析

目的,了解我县肺结核病人对常用抗结核药物的敏感情况。方法,利用高低两个药物浓度分别检测172株结核分枝杆菌对异烟肼（INH）、链霉素（SM）、乙胺丁醇（EMB）、利福平（RFP）的耐药性。结果,172株结核分枝杆菌全敏感81株占47．1％,耐药91株占52．9％。结论单一耐药高于同时耐两种药,同时耐两种药高于耐三种药,低浓度耐药高于高浓度耐药。     

结核分枝杆菌喹诺酮类药物耐药与基因突变关系的研究

目的:探讨喹诺酮类药物的耐药性与结核分枝杆菌gyrA基因突变的关系。方法:采用比例法检测结核分枝杆菌中氧氟沙星耐药的菌株,并对氧氟沙星耐药菌株的gyrA基因的耐药决定区域进行序列测定。结果:175株结核分枝杆菌中,耐氧氟沙星菌株为30.9%(54/175),其中81.5%(44/54)的菌株gyrA基因的喹诺酮耐药决定区发生突变。结论:在结核病人中存在着较严重的耐喹诺酮药物情况,因此对结核病人选择喹诺酮药物治疗时,最好先进行喹诺酮药物的耐药检测,gyrA基因突变的检测可预测菌株对喹诺酮类药物的耐药表型。     

布鲁菌利福霉素耐药与rpoB基因突变的相关性研究

目的采用现代分子生物学技术,应用MSW理论观测布鲁菌耐药问题,探讨布鲁菌在利福霉素选择压力下出现的突变特征。方法富集10^10cfu／mL布鲁菌,采用琼脂稀释法测定利福平和利福布丁对布鲁菌的最低抑菌浓度及防突变浓度。PCR扩增不同药物浓度筛选出的耐药突变株的rpoB基因并测序。结果利福平和利福布丁对布鲁菌的防突变浓度分别为460mg／L和512mg／L,细菌耐药选择指数为115和728。筛选出的耐药突变株中均检测出rpoB基因突变。结论调整药物剂量可防止对利福霉素耐药的布鲁菌突变株的富集。布鲁菌的利福霉素耐药株中H536Y突变体最为稳定。     

牛贝消核提取物对耐多药结核分枝杆菌和非结核分枝杆菌的体外抑菌作用的研究

目的研究不同工艺制备的中药复方牛贝消核提取物的体外抑菌活性,为制备抗结核中成药制剂提供实验基础。方法制备分别含50,100,200 g·L-1牛贝消核水提取物、醇提取物的改良罗氏培养基,并分别制备含1,10μg/ml异烟肼(Isonicotinic acid hydrazide,INH)和50,250μg·ml-1利福平(Rifampicin,RFP)的改良罗氏培养基为对照,将3株耐多药结核分枝杆菌分离株、牛结核分枝杆菌和4株非结核分枝杆菌分别接种于含药的改良罗氏培养基中,置37℃培养4周,测定其最低抑菌浓度(MICs)。结果牛贝消核水提取物对这8株供试菌的MICs均为200 g·L-1;醇提取物对牛结核分枝杆菌和母牛分枝杆菌的MICs均为100 g·L-1,对3株耐多药结核分枝杆菌分离株、胞内、瘰疬、偶发分枝杆菌的MICs均为200 g·L-1。结论牛贝消核水提取物和醇提取物对敏感或耐药的结核分枝杆菌和非结核分枝杆菌均有不同程度的抑制作用,醇提取物的抑菌活性比水提取物略强。     

广东顺德区结核分枝杆菌临床耐药性分析

目的:了解本地区结核分枝杆菌临床耐药性的特点以及对7种抗结核药物的药敏检测情况,为临床制定合理的治疗方案提供更多的参考依据。方法:对收集的广东顺德区555例结核患者的结核分枝杆菌用比例法对所用的7种药:异烟肼(INH,H)、乙胺丁醇(EMB,E)、链霉素(SM,S)、利福平(RFP,R)、阿米卡星(AKW,A)、左氧氟沙星(LOF,L)、对氨基水杨酸(PAS,P)进行敏感性试验,分析它们的耐药性。结果:总耐药率为33%,耐药频度由高到低依次为SM19.8%、INH12.8%、LOF8.6%、RFP4.5%、EMB3.6%、PAS3.1%、AKW1.4%。结论:本地结核菌的耐药性相比其他地区略偏高,应进一步加强对结核杆菌的耐药性监测以便为临床制定更合理的治疗方案提供参考依据。     

耐药肺结核分枝杆菌快速诊断和治疗研究进展

目的综述近年对耐药肺结核快速诊断及治疗的研究进展。方法查阅国内外大量文献,对耐药结核病的诊断及其中西医药治疗情况进行分析归纳。结果耐药肺结核快速诊断主要依靠分子生物学检测;耐药结核病化疗配合免疫、外科手术及中西医药结合治疗。结论分子生物学检测提高快速诊断耐药肺结核效率,但由于设备、技术、费用等因素难以普及需进一步探索;快速有效治疗方法仍在探索阶段。     

结核分枝杆菌H37Rv结合肽的筛选研究

<正>在当今社会,结核病仍然是困扰人们的传染病之一,给人类的身体健康带来不利影响,病死率依旧很高[1]。中国死于结核病的人数位居世界前列,并且感染人数也较多,由于药物使用不当,还出现了耐药结核病,造成结核病难以治愈,给患者的身体带来不可逆伤害,影响患者的健康。为了减少疾病的发生,如何检测病原体就成为医学专家研究的重点。本研究通过进行结核分枝杆菌     

非结核分枝杆菌的药敏检测

最近由于结核病的发病有上升趋势,难治、复治结核病有所增加。在难复治结核病患者中,非结核分枝杆菌(NTM)感染已引起广泛重视,其临床症状酷似结核分枝杆菌结核病,病程较长,呈反复咳嗽、发热、咯血,痰液涂片镜检抗酸杆菌部分病例阳性,一线抗痨药物治疗疗效差或无效,痰菌持续呈阳     

结核分枝杆菌抗体在肺结核患者中的临床研究

目的:应用痰涂片查抗酸杆菌、胶体金法检测结核分枝杆菌抗体、X线胸片三种方法,对诊断肺结核进行对比评估。方法:对我院确诊的108例肺结核患者的血清进行结核分枝杆菌抗体检测,同时做痰涂片查抗酸杆菌及X胸片检查。结果:采用血清进行结核分枝杆菌抗体检测有78例阳性,X胸片检查有84例阳性,痰涂片查抗酸杆菌有46例阳性。以胶体金法测结核分枝杆菌抗体与X线胸片两法具有较好的敏感性,差异无统计学意义(P>0.05)。在108例认定肺结核的标本进行检测结果分析,痰涂片阳性率为42.6%与结核分枝杆菌抗体的阳性率为72.2%和X线胸片阳性率为77.8%差异均具有统计学意义(P<0.05)。结论:血清结核分枝杆菌抗体检测在肺结核诊断中具有方便、快速、敏感、特异的特点,结合X胸片检查具有更高的临床应用价值。     

一种快速判断对利福布汀敏感的 利福平耐药菌株的简易方法

〔摘 要〕 目的：利用结核分枝杆菌 / 利福平耐药荧光定量核酸扩增检测技术（Xpert MTB/RIF,简称 Xpert 检测）中各 探针的检测结果,判断在对利福平（RFP）耐药的菌株中,是否同时对利福布汀（RFB）耐药。方法：收集 2018 年 6 月至 2021 年 5 月在深圳市第三人民医院就诊的耐药结核患者共 548 例。收集患者的各类标本,包括痰、支气管肺泡灌洗液、胸水、 脑脊液、尿液、脓液、病理组织及穿刺物等进行分枝杆菌培养。然后对培养物分别进行 Xpert 检测及结核快速药敏试验（绝 对浓度法）。以绝对浓度法为金标准,将 Xpert 检测提示耐药的结果与金标准中 RFB 的结果进行对照分析。结果：Xpert 检 测结果任何一个探针阳性,提示对 RFB 交叉耐药的检验综合符合率在 51.64 %。Xpert 检测中 A、C、D ＋ E 探针阳性的菌 株,提示对 RFP 存在耐药,但对 RFB 全部敏感,其他探针对药物灵敏度的指示意义不大。以绝对浓度法结果作为金标准, Xpert 检测各探针对 RFB 耐药性的检测结果具有不同的灵敏度与特异度。结论：Xpert 检测结果部分探针阳性,可以用来作 为耐 RFP 患者选取 RFB 替代的指示性标志。     

Activity of Scottish Plant,Lichen and Fungal Endophyte Extracts against Mycobacterium aurum and Mycobacterium tuberculosis

With tuberculosis the leading bacterial killer worldwide and other mycobacterial diseases on the increase, the search for new antimycobacterial agents is timely. In this study, extracts from plants, lichens and fungal endophytes of Scottish provenance were screened for activity against Mycobacterium aurum and M. tuberculosis H₃₇Rv. The best activity against M. aurum was observed for extracts of Juniperus communis roots and Cladonia arbuscula (MIC = 4 µg/mL), and a fungal endophyte isolated from Vaccinium myrtillus (MIC = 8 µg/mL). The best activity against M. tuberculosis was observed for extracts of C. arbuscula, Empetrum nigrum, J. communis roots, Calluna vulgaris aerial parts, Myrica gale roots and stems (93 to 99% inhibition at 100 µg/mL). Potent antitubercular activity (90 to 96% inhibition at 100 µg/mL) was also observed for the ethanol extracts of Xerocomus badius, Chalciporus piperatus, Suillus luteus and of endophytes isolated from C. vulgaris, E. nigrum, Vaccinium vitis‐idaea and V. myrtillus. The results obtained this study provide, in part, some scientific basis for the traditional use of some of the selected plants in the treatment of tuberculosis. They also indicate that fungal endophytes recovered from Scottish plants are a source of antimycobacterial agents worthy of further investigation. Copyright © 2009 John Wiley & Sons, Ltd.     

Activity against Mycobacterium smegmatis and M. tuberculosis by extract of South African medicinal plants

Seven ethnobotanically selected medicinal plants were screened for their antimycobacterial activity. The minimum inhibitory concentration (MIC) of four plants namely Artemisia afra, Dodonea angustifolia, Drosera capensis and Galenia africana ranged from 0.781 to 6.25 mg/mL against Mycobacterium smegmatis. G. africana showed the best activity exhibiting an MIC of 0.78 mg/mL and a minimum bactericidal concentration (MBC) of 1.56 mg/mL. The MICs of ethanol extracts of D. angustifolia and G. africana against M. tuberculosis were found to be 5.0 and 1.2 mg/mL respectively. The mammalian cytotoxicity IC(50) value of the most active antimycobacterial extract, from G. africana, was found to be 101.3 microg/mL against monkey kidney Vero cells. Since the ethanol G. africana displayed the best antimycobacterial activity, it was subjected to fractionation which led to the isolation of a flavone, 5,7,2'-trihydroxyflavone. The MIC of this compound was found to be 0.031 mg/mL against M. smegmatis and 0.10 mg/mL against M. tuberculosis. This study gives some scientific basis to the traditional use of these plants for TB-related symptoms.     

Activity against multidrug-resistant Mycobacterium tuberculosis in Mexican plants used to treat respiratory diseases

The increase of multidrug-resistant Mycobacterium tuberculosis (MDR-TB) demands the search for alternative antimycobacterial drugs. The aim of this study was to evaluate plants used in Mexican traditional medicine to treat respiratory diseases for activity against MDR-TB. A group of 22 plants was screened for activity against Mycobacterium tuberculosis H37Rv and Mycobacterium avium at concentrations from 50 to 200 microg/mL. The antimycobacterial effect was determined by a microcolorimetric assay with Alamar blue dye. None of the aqueous extracts had antimycobacterial activity. Hexane extracts from Artemisia ludoviciana, Chamaedora tepejilote, Lantana hispida, Juniperus communis and Malva parviflora, and methanol extracts from Artemisia ludoviciana and Juniperus communis inhibited the growth of Mycobacterium tuberculosis. Mycobacterium avium was inhibited by Juniperus communis hexane extract and by Malva parviflora methanol extract. The active extracts were tested against monoresistant variants of Mycobacterium tuberculosis H37Rv (isoniazid, rifampin, streptomycin and ethambutol resistant) and the hexane extract of Lantana hispida showed the best activity. Lantana hispida hexane extract was also active against a group of MDR-TB clinical isolates. In contrast, it did not inhibit the growth of non-tuberculous mycobacteria. The hexane extract of Lantana hispida was fractionated by column chromatography and one of its fractions (FVI) inhibited the growth of all the MDR-TB clinical isolates at concentrations up to 25 microg/mL. This study supports the fact that selecting plants by ethnobotanical criteria enhances the probability of finding species with activity against mycobacteria, and our results point to Lantana hispida as an important source of potential compounds against MDR-TB.     

7种蛇毒小肽对临床分离耐（多）药结核分枝杆菌的体外活性研究

 目的检测7种从蛇毒分离的小肽是否对临床分离的耐药性结核分枝杆菌菌株具有活性。方法放射性方法检测蛇毒小肽对结核分枝杆菌的最小抑制浓度，细菌存活计数确证放射性方法的结果。结果7种蛇毒小肽对耐药性结核分枝杆菌菌株都有活性。其MIC值分别为(μg·mL_-1)：Opiophagus hannah 5.4，Naja atra 8.6，Bungarus fasciatus 6.4，Trimeresurus stejnegri 12.6，Protobothrops mucrosquamatus 11.8，Protobothrops jerdonii 7，Agksistrodon halys 4.2。结论这些结果是首次报道，为进一步设计和开发新来源的抗结核病新药提供了依据。     

Antibacterial activity of ergosterol peroxide against Mycobacterium tuberculosis: dependence upon system and medium employed

Ergosterol peroxide, cycloart-23-en-3beta,25-diol, vanillin and 4-hydroxybenzaldehyde have been isolated and characterized from a crude methanol extract of Euphorbia lagascae. Previous studies have shown contradictory results about the antibacterial activity of ergosterol peroxide against Mycobacterium tuberculosis. In order to clarify this question, the activity of this compound was tested against Mycobacterium tuberculosis H37Rv ATCC 27294 strain using two different systems: BACTEC 460TB (Bactec 460) and BACTEC MGIT 960 system (Bactec 960). The results obtained show that significant activity was demonstrable only with the Bactec 460 system. The lack of activity noted with the Bactec 960 system appears to be due to the much faster growth rate of the organism in the medium of this system as opposed to that of the Bactec 460 system. Ergosterol peroxide is also shown by the current study to be devoid of any activity against an antibiotic sensitive ATCC strain of Staphylococcus aureus.     

白花丹素对结核分枝杆菌H37RV基因表达谱的影响

目的研究白花丹素(PL)对结核分枝杆菌的基因表达谱的影响。方法微量稀释法确定PL对结核分枝杆菌H37RV的MIC,1/2×MIC作用4 h后收集细菌,提取RNA,基因芯片检测PL对结核分枝杆菌的基因表达谱的影响,RT-PCR确证芯片结果。结果在PL的作用下总共有274个基因出现差异表达,其中有103个基因表达上调,171个基因表达下调。结论 PL有效调控了许多重要的功能基因表达,为研究PL抗结核分枝杆菌的分子作用机制提供了依据。     

Activity against drug resistant-tuberculosis strains of plants used in Mexican traditional medicine to treat tuberculosis and other respiratory diseases

Tuberculosis (TB) kills about 3 million people per year worldwide. Furthermore, TB is an infectious disease associated with HIV patients, and there is a rise in multidrug-resistant TB (MDR-TB) cases around the world. There is a need for new anti-TB agents. The study evaluated the antimycobacterial activity of nine plants used in Mexican traditional medicine to treat tuberculosis and other respiratory diseases. Nasturtium officinale showed the best activity (MIC = 100 microg/mL) against the sensitive Mycobacterium tuberculosis. The following plants were active also but at 200 microg/mL: Citrus sinensis, Citrus aurantifolia, Foeniculum vulgare, Larrea tridentata, Musa acuminata and Olea europaea. Contrary to the above data, activity against drug-resistant variants of M. tuberculosis was more evident, e.g. N. officinale was the most potent (MIC < or = 100 microg/mL) against the four mono-resistant variants tested; F. vulgare and O. europaea were active against all the resistant variants (MICs < or = 100 microg/mL). The most susceptible variant was the isoniazid resistant, being inhibited by C. aurantifolia, C. sinensis and O. europaea (MIC = 25 microg/mL). These data point to the importance of biological testing of extracts against drug-resistant M. tuberculosis isolates, and the bioguided assay of these extracts for the identification of lead compounds against MDR-TB isolates.     

荧光定量 PCR 检测结核杆菌 DNA 与涂片 抗酸染色诊断肺结核的效果比较

〔摘 要〕 目的：比较荧光定量聚合酶链式反应（PCR）检测结核杆菌脱氧核糖核酸（DNA）与涂片抗酸染色诊断肺结 核的效果。 方法：收集 2017 年 1 月至 2020 年 12 月在新乡市第一人民医院就诊的疑似肺结核患者 95 例的痰液标本 127 份, 对所有痰液标本均实施荧光定量 PCR 检测结核杆菌 DNA 及涂片抗酸染色检测,以痰培养结果为金标准,比较两种检测方 法的诊断效能。 结果：痰培养结果显示,95 例疑似肺结核患者中,61 例患者确诊,确诊率为 64.21 %。荧光定量 PCR 检测 的准确度、特异度、灵敏度及阳性预测值、阴性预测值均明显高于涂片抗酸染色检测,差异均具有统计学意义（P ＜ 0.05）。 结论：荧光定量 PCR 检测结核杆菌 DNA 对肺结核的诊断效能明显高于涂片抗酸染色检测。     

肺结核丸治疗难治性肺结核随机对照临床研究

[目的]探讨肺结核丸治疗难治性肺结核的临床效果。[方法]将我院收治的60例难治性肺结核患者,随机分为对照组和治疗组,对照组采用异烟肼联合利福平治疗,治疗组肺结核丸治疗。分析两组治疗效果及不良反应发生情况。[结果]治疗组总有效率与对照组相比,差异无统计学意义(P>0.05)。治疗组显效率显著高于对照组,差异有统计学意义(P<0.05)。治疗组病灶吸收率显著高于对照组,差异有统计学意义(P<0.05)。[结论]采用肺结核丸治疗难治性肺结核,疗效优于利福平联合异烟肼治疗,病灶恢复良好,使用方便,值得临床推广应用。     

趋化因子RANTES基因多态性和肺结核易感性的关系

目的研究RANTES基因启动子区-403G/A、-28C/G和内含子区Inl.1T/C的多态性和结核病易感性之间的关系。方法采用病例对照研究方法,应用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)对78例结核病患者(病例组)和97例健康对照者(对照组)的RANTES-403G/A、-28C/G和Inl.1T/C多态性进行基因分型,分析这三个位点多态性与结核病发生率的关系。结果 2组RANTES-403G/A位点GG、GA和AA基因型的分布频率比较差异无统计学意义(x2=0.41,P0.05),G、A等位基因分布频率差异无统计学意义(x2=0.30,P0.05)。2组RANTES-28C/G位点CC、CG和GG基因型的分布频率比较差异无统计学意义(x2=0.15,P0.05),C、G等位基因分布频率差异无统计学意义(x2=0.02,P0.05)。2组RANTES Inl.1T/C位点TT、TC和CC基因型的分布频率比较差异无统计学意义(x2=0.53,P0.05),T、C等位基因分布频率差异无统计学意义(x2=0.19,P0.05)。结论 RANTES基因启动子区的-403G/A、-28C/G和内含子区的Inl.1T/C位点的单核苷酸多态性(SNP)与肺结核感染的易感性不相关。