河南省结核分枝杆菌北京家族基因型及耐药分析

Prevalence of Beijing genotype family of Mycobacterium tuberculosis isolated in Henan province and its correlation with drug-resistance

目的了解河南省结核分枝杆菌北京家族基因型的分布、流行特点、与耐药性的相关性。方法 2009年6月-2010年11月在河南省尉氏县结核病防治机构实验室分离培养的165株结核分枝杆菌,采用比例法进行药物敏感性检测,应用RD 105缺失基因检测法和琼脂糖凝胶电泳技术进行北京家族基因型鉴定。结果 164株结核分枝杆菌对4种一线抗结核药物,异烟肼(IN H)、利福平(RFP)、链霉素(SM)和乙胺丁醇(EMB)药敏情况:全部敏感的菌株为126株(76.8%);任意耐药菌株38株(23.2%),其中,单耐药菌株14株(8.5%),多耐药菌株24株(14.6%);结核分支杆菌对4种一线药的耐药率依次为:INH 16.5%(27/164)、SM 15.9%(26/164)、RFP 9.1%(15/164)、EMB 7.3%(12/164)。164株结核分枝杆菌中,北京家族基因型(Beijing fam ily)占89.6%(147/164),17株为非北京家族基因型,占10.4%;147株北京家族基因型菌株中,全部敏感的菌株为111株(75.5%);耐任一种药菌株36株(24.5%),其中耐多药(MDR)菌株13株(8.8%);而17株非北京家族基因型菌株中耐药菌株2株(11.76%),敏感菌株为15株(88.23%),无MDR菌株,经2χ检验,两者间的差异无统计学意义(2χ=0.365,P>0.05)。结论河南省结核分枝杆菌的耐药情况较为严重,以北京家族基因型流行为主,结核分枝杆菌北京家族基因型与耐药性之间无明显相关性。

Objective To understand the status of drug-resistance of Mycobacterium tuberculosis（M.tuberculosis） isolated from Weishi,Henan province,and its correlation with Beijing genotype family.Methods The drug susceptibility of the clinical isolates of M.tuberculosis was determined by proportion method and the genotypes were identified by RD105 deletion test.The statistical analysis was performed with χ2 test.Results Among 164 clinical isolates of M.tuberculosis,126 strains（76.8%） were sensitive to 4 first line anti-tuberculosis drugs,including isoniazid（INH）,rifampicin（RFP）,streptomycin（SM）,and ethambutol（EMB）,whereas 38 strains（23.2%） were resistant to the 4 drugs,in which 14 strains（8.5%） were single drug-resistant and 13 strains（7.9%） belonged to multi-drug resistance（MDR）.The percentages of drug resistance to INH,SM,RFP,and EMB were 16.5%（27/164）,15.9%（26/164）,9.1%（15/164）,and 7.3%（12/164）,respectively.As demonstrated by genotyping,147 strains of 164 M.tuberculosis isolates（89.6%） belonged to Beijing family and others were non-Beijing family.Among the 147 Beijing family strains,36 strains（24.5%） were drug-resistant,and 111 strains（75.5%） were sensitive.Among 17 non-Beijing family strains,2 strains（11.76%） were drug-resistant and 15 strains（88.23%） were sensitive.Concerning to the drug-resistance,there was no significant difference between the Beijing family strains and the non-Beijing family（χ2 = 0.05,P0.05）.Conclusion The status of drug-resistance of M.tuberculosis in Henan is serious and no correlation exists between the drug-resistance of M.tuberculosis and Beijing family genotypes.