青海省251株结核分枝杆菌Spoligotyping基因型与4种一线药物耐药表型的研究

目的研究青海结核分枝杆菌对4种一线抗结核药物耐药状况及与Spoligotyping基因型的关系,为结核病有效预防提供依据。方法采用常规比例法对分离的251株结核分枝杆菌进行异烟肼(INH)、利福平(RFP)、链霉素(SM)和乙胺丁醇(EMB)等4种一线抗结核药物的药敏试验,并对菌株进行Spoligotyping分型,对药敏试验和基因分型结果进行综合分析。结果 251株结核分枝杆菌中,总耐药率为56.2%;对INH、RFP、SM和EMB的耐药率分别为43.0%(108/251)、37.1%(93/251)、39.0%(98/251)和27.9%(70/251);耐多药率为31.5%(79/251)。所有菌株经Spoligotyping分型,分为北京基因型185株(73.7%)与非北京型菌株66株(26.3%)。未发现北京型与非北京型结核菌株与耐药存在统计学关联。结论青海流行的结核分枝杆菌耐药率及多耐药率较高,Spoligotyping分型显示北京基因型为主要流行型。

Investigation on spoligotyping and phenotypes of drug resistance to four first-line drugs in 251 Mycobacterium tuberculosis isolates from Qinghai,China

This study aims to learn drug resistance situation of four first-line anti TB drugs among 251 Mycobacterium tuberculosis isolates from Qinghai and to explore their relationships with genotypes by Spoligotyping,so as to provide basis for effective prevention of tuberculosis.Isolates of 251 M.tuberculosis were tested susceptibilities of four first-line drugs including isoniazid (INH),rifampicin (RFP),streptomycin(SM) and ethambutol (EMB) by using conventional proportion method and genotyped by Spoligotyping.Relationship between drug resistance and genotypes was analyzed statistically.Results showed the total drug resistance rate was 56.2％ (141/251) among 251 M.tuberculosis isolates.Resistance rates of four first-line drugs were 43.0％ (108/251) for INH,37.1％ (93/251) for RFP,39.0％ (98/251) for SM,27.9％ (70/251) for EMB respectively.Rate of multidrug-resistant TB (MDR TB) was 31.5％ (79/251).All 251 isolates of M.tuberculosis were typed by spoligotyping.The 185 (73.7 ％) were Beijing genotypes and 66 (26.3.％) were non-Beijing genotypes,and no statistical association was found with drug resistance.This paper concludes that isolates of M.tuberculosis prevail in Qinghai have both high rates of drug resistance and MDR and dominant isolates are Beijing genotypes by spoligotyping.