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目的研究结核分枝杆菌北京基因型菌株与结核患儿耐药表型及其相关因素。方法采用定向缺失多重酶链聚合反应技术(deletion-targeted multiplex PCR,DTM-PCR)对从143例患儿分离得到的结核分枝杆菌进行北京基因型菌株鉴定,并使用绝对浓度法进行药敏实验。收集患者的性别、年龄、居住地、卡介苗接种史和结核性脑膜炎病史等相关因素资料。采用χ2检验和Fisher确切概率法分析北京基因型与相关因素以及耐药表型之间的关系。结果在143株结核分枝杆菌中,91株为北京基因型,占63.6%,北京基因型菌株与年龄、性别、居住地、卡介苗接种和结核性脑膜炎无关(P>0.05)。北京基因型菌株在耐链霉素菌株(16.5%,15/91)和耐异烟肼菌株(15.4%,14/91)中的比例显著高于非北京基因型(3.8%,2/52;3.8%,2/52)(P<0.05)。结论北京基因型菌株是重庆地区儿童结核患者中流行的优势菌群,患儿的年龄、性别、居住地、是否接种卡介苗和是否为结核性脑膜炎与北京基因型菌株无关,感染北京基因型菌株的结核患儿更易出现链霉素和异烟肼耐药。
Objective To study the drug resistance phenotype and related factors of Mycobacterium tuberculosis isolates and tuberculosis in Beijing. Methods Mutations-targeted multiplex PCR (DTM-PCR) was used to identify the genotypes of Mycobacterium tuberculosis isolated from 143 children in Beijing and the antibiotic susceptibility test was performed using the absolute concentration method . Collect the patient’s gender, age, place of residence, history of BCG vaccination and history of tuberculous meningitis and other related information. Chi-square test and Fisher’s exact test were used to analyze the relationship between Beijing genotype and related factors and drug resistance phenotype. Results Of the 143 strains of M. tuberculosis, 91 strains were Beijing genotypes, accounting for 63.6%. The genotypes of Beijing strains were not related to age, sex, residence, BCG vaccination and tuberculous meningitis (P> 0.05). The proportion of Beijing genotype strains in streptomycin-resistant strains (16.5%, 15/91) and isoniazid-resistant strains (15.4%, 14/91) was significantly higher than that in non-Beijing genotypes (3.8%, 2/52; 3.8%, 2/52) (P <0.05). Conclusion The genotypes of Beijing genotype are the prevailing dominant microflora among children with tuberculosis in Chongqing. The age, gender, residence, BCG vaccination and tuberculous meningitis are not associated with Beijing genotype strains. Of tuberculosis patients are more susceptible to streptomycin and isoniazid resistance.