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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。
Objective To study the drug resistance of Mycobacterium tuberculosis to four kinds of first-line anti-tuberculosis drugs in Qinghai and its relationship with Spoligotyping genotypes, so as to provide basis for effective prevention of tuberculosis. Methods 251 strains of Mycobacterium tuberculosis isolates of INH, RFP, SM and ethambutol (EMB) were isolated by conventional proportional method. Drug susceptibility test, and strain Spoligotyping classification, drug susceptibility testing and genotyping results were analyzed. Results The total drug resistance rate of 251 strains of Mycobacterium tuberculosis was 56.2%. The resistance rates to INH, RFP, SM and EMB were 43.0% (108/251), 37.1% (93/251) and 39.0% 98/251) and 27.9% (70/251) respectively. The rate of multi-drug resistance was 31.5% (79/251). All strains were genotyped by Spoligotyping and divided into 185 genotypes in Beijing (73.7%) and 66 (26.3%) genotypes in non-Beijing strains. No correlation was found between Beijing-type and non-Beijing-type tuberculosis strains and drug resistance. Conclusion The prevalence of M. tuberculosis in Qinghai is high and the rate of multidrug resistance is high. Spoligotyping shows that Beijing genotype is the predominant epidemic.