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许河南, 杨红慧, 赖聪娟, 吴燕飞, 林利, 季柏林, 徐丽霞. 浙江省丽水市结核分枝杆菌临床分离株耐药性及基因突变情况[J]. 疾病监测, 2023, 38(1): 51-56. DOI: 10.3784/jbjc.202205260243
引用本文: 许河南, 杨红慧, 赖聪娟, 吴燕飞, 林利, 季柏林, 徐丽霞. 浙江省丽水市结核分枝杆菌临床分离株耐药性及基因突变情况[J]. 疾病监测, 2023, 38(1): 51-56. DOI: 10.3784/jbjc.202205260243
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Xu Henan, Yang Honghui, Lai Congjuan, Wu Yanfei, Lin Li, Ji Bolin, Xu Lixia. Drug resistance and gene mutation of clinical isolates of Mycobacterium tuberculosis in Lishui, Zhejiang[J]. Disease Surveillance, 2023, 38(1): 51-56. DOI: 10.3784/jbjc.202205260243
Citation: Xu Henan, Yang Honghui, Lai Congjuan, Wu Yanfei, Lin Li, Ji Bolin, Xu Lixia. Drug resistance and gene mutation of clinical isolates of Mycobacterium tuberculosis in Lishui, Zhejiang[J]. Disease Surveillance, 2023, 38(1): 51-56. DOI: 10.3784/jbjc.202205260243
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浙江省丽水市结核分枝杆菌临床分离株耐药性及基因突变情况

Drug resistance and gene mutation of clinical isolates of Mycobacterium tuberculosis in Lishui, Zhejiang

    摘要
  • 摘要:
      目的  调查浙江省丽水市结核病定点医院患者结核分枝杆菌（MTB）临床分离株耐药特征及耐药基因突变情况，为该地区耐药结核病防控提供依据。
      方法  采用荧光PCR熔解曲线法对培养自丽水市结核病定点医院结核病患者MTB临床分离株进行抗结核药物耐药性及耐药基因突变位点检测及分析。
      结果  242株MTB总耐药突变占16.53%（40/242），耐多药率为4.96%（12/242），耐药顺位分别为异烟肼>链霉素>利福平>氟喹诺酮类 >乙胺丁醇。 链霉素耐药株基因突变位点主要发生在rpsL43位密码子，占比为65.00%（13/20）；异烟肼耐药基因突变位点主要发生在katG315密码子，占比为76.19%（14/21）；利福平耐药基因突变位点主要发生在rpoB基因529-533位密码子，占比为61.11%（11/18）； 乙胺丁醇耐药基因突变位点主要发生在embB306位密码子，占77.78%（7/9）。
      结论  丽水市结核患者总体耐药突变低于全国耐药水平，但耐药模式和耐药基因突变情况仍较为复杂，需进一步加强耐药结核病监测及防控工作。

     

    Abstract:
      Objective  To study the drug resistance characteristics and drug resistance gene mutations of 242 Mycobacterium tuberculosis clinical isolates from a designated tuberculosis hospital in Lishui and provide evidence for the prevention and control of drug-resistant tuberculosis in Lishui.
      Methods  The drug resistance and resistance gene mutation characteristics of the M. tuberculosis clinical isolates in Lishui were detected by fluorescence PCR melting curve method.
      Results  The overall drug resistance rate of 242 M. tuberculosis strains was 16.53% (40/242), and the multidrug resistance rate was 4.96% (12/242), and the resistance to isoniazid was highest, followed by streptomycin, rifampicin, fluoroquinolones and ethambutol. The mutation site of streptomycin resistance gene mainly occurred at codon rpsL43, the mutation rate was 65.00% (13/20); the mutation site of isoniazid resistance gene mainly occurred at katG315 codon , the mutation rate was 76.19% (14/21); the rifampicin resistance gene mutation sites mainly occurred at codons 529–533 of the rpoB gene, with a mutation rate of 61.11% (11/18); The mutation site of ethambutol resistance gene mainly occurred at codon 306 of embB, and the mutation rate was 77.78% (7/9).
      Conclusion  The overall drug resistance rate in tuberculosis patients in Lishui is lower than the national average levels, but the drug resistance patterns and drug resistance gene mutations are still complex and diverse, and the clinical prevention and control of drug-resistant tuberculosis needs to be further strengthened.

     

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