结核分枝杆菌西安分离株北京家族基因型检测及其耐药相关性研究

目的了解西安市结核分枝杆菌临床分离株的耐药情况及其与北京家族基因型(Beijing Family)的相关性,为有效防治结核病提供依据。方法对临床分离结核分枝杆菌采用绝对浓度法进行药物敏感性检测。间隔寡核苷酸分型(Spoli-gotyping)方法进行北京家族基因型鉴定。结果统计学分析采用χ2检验。结果104株结核分枝杆菌对4种一线抗结核药物,异烟肼(INH)、利福平(RFP)、链霉素(SM)和乙胺丁醇(EMB),全部敏感的菌株为71株(68.3%);耐药菌株33株(31.7%),其中,单耐药菌株12株(11.5%),耐多药菌株21株(20.2%)。结核分枝杆菌对4种一线药物INH、RFP、SM和EMB的耐药率分别为24.04%(25/104)、18.69%(19/104)、16.34%(17/104)和2.88%(3/104)。104株结核分枝杆菌中北京家族基因型(BeijingFamily)占全部菌株的83.7%,非北京家族基因型占16.3%。87株北京家族基因型菌株中耐药菌株28株(32.18%),敏感菌株59株(67.82%),而17株非北京家族基因型菌株中耐药菌株5株(29.41%),敏感菌株为12株(70.59%)。经统计学分析其差异无统计学意义(χ2=0.05,P>0.05)。结论西安市分枝杆菌的耐药情况较为严重。结核分枝杆菌北京家族基因型与耐药性之间无明显相关性。

The status of drug-resistance on Mycobacterium tuberculosis isolated from Xi'an City,and its correlation with the genotyping of the Beijing family

To understand the status of drug-resistance on Mycobacterium tuberculosis(M.tuberculosis)isolated from Xi'an City,Shanxi province,and its correlation with genotyping of Beijing family,the drug susceptibility of the clinical isolates of M.tuberculosis was determined by absolute concentration method and the genotypes were identified by Spoligotyping.Meanwhile the statistical analysis was performed with χ2 test.It was found that among 104 clinical isolates of M.tuberculosis,71 strains(68.3%)were sensitive to 4 first line anti-tuberculosis drugs,i e isoniazid,(INH),rifampicin(RFP),streptomycin(SM)and ethambutol(EMB),while 33 strains(31.7%)were resistant to these 4 drugs,in which 12 strains(11.5%)were single drug-resistant,and 21 strains(20.2%)belonged to the multi-drug resistance(MDR).The percentages of drug resistance to INF,RFP,SM and EMB were 24.04%(15/104),18.69%(19/104),16.34%(17/104)and 2.88%(3/104)respectively.As demonstrated by genotyping with Spoligotyping,87 strains of 104 M.tuberculosis isolates(83.7%)belonged to the Beijing family and the others were the non-Beijing family.Among 87 Beijing family strains,28 strains(32.18%)were drug-resistant,and 59 strains(57.82%)were drug-sensitive,while among 17 non-Beijing family strains,5 strains(29.41%)were drug-resistant,and 12 strains(70.59%)were drug-sensitive.Concerning to the drug-resistance,there was no significant difference to the Beijing family as well as the non-Beijing family(χ2=0.05,P>0.05).From the above observation,it is concluded that the status of drug-resistance on M.tuberculosis in Xi'an City is rather grave and no correlation exists between the drug-resistance of M.tuberculosis and the genotyping of Beijing family genotypes.