重庆市结核分枝杆菌临床分离株的基因分型及相关耐药性分析

目的 对重庆市结核分枝杆菌临床分离株进行基因分型，研究不同基因型在重庆的流行情况，并分析基因型与耐药表型的关系。 方法 收集2011年1-12月重庆市结核病防治所分离的113株结核分枝杆菌临床分离株，采用比例法进行药物敏感性检测；应用间隔区寡核苷酸分型（Spoligotyping）和PCR方法对113株结核分枝杆菌临床分离株进行基因分型。 结果 在113株结核分枝杆菌临床分离株中，可分为北京家族和非北京家族，分别占77株（68.1%，77/113）和36株（31.9%，36/113）；北京家族菌株中现代型为48株（62.3%，48/77），古代型为29株（37.7%，29/77）；非北京家族菌株中，T1型高达13株（36.1%，13/36），发现9种新基因型。北京家族菌株耐药率为24.7%（19/77），非北京家族菌株耐药率为38.9%（14/36），差异无统计学意义（χ²=2.40，P>0.05）。现代型北京家族菌株耐药率为27.1%（13/48），古代型北京家族菌株耐药率为20.7%（6/29），差异无统计学意义（χ²=0.39，P>0.05）。 结论 重庆地区结核分枝杆菌具有明显的基因多态性，其主要流行基因型为北京家族，其中北京家族中主要为现代型；北京家族菌株、非北京家族菌株均与耐药性无明显相关性。

Genotyping and drug resistance analysis of M. tuberculosis clinical isolates in Chongqing

Objective To study the prevalence of different genotypes of M. tuberculosis in Chongqing and analyze the relationships between genotype and drug-resistant phenotype. Methods One hundred and thirteen M. tuberculosis clinical isolates were collected in Chongqing from January to December in 2011, performed drug suscepti- bility testing by the proportion method, analyzed the genotypes by Spoligotyping and PCR method, and then made gene glustering analysis. Results One hundred and thirteen clinical strains were divided into 2 gene clusters, namely Beijing family （68.1%, 77/113） and non-Beijing family （31.9%, 36/113）. Of 77 Beijing family strains, 48 （62.3%） strains were belong to modern type, 29 （37.7%） were the ancient type. Of 36 strains with non-Beijing family, 13 （36.1%） strains were T1 type, and found 9 new genotypes. The drug-resistant rate of Beijing family strains was 24.7% （19/77） ,and of non-Beijing family strains was 38. 9% （14/36）, in which there was no signifi- cant differences （X^2=2.40, P〉0. 05）. The drug-resistant rate of modern type strains in Beijing family was 27.1% （13/48）, and of the ancient type strains was 20. 7% （6/29）, in which there was no significant differences （X^2=0. 39, P〉0. 05）. Conclusion There was obvious gene polymorphism in M. tuberculosis isolates in Chongqing. Beijing family was the main epidemic strains, in which the modem type was predominant. There was no significant correlation between genotype and drug resistance.