结核性脑膜炎临床分离株的耐药性和基因型相关性分析

Analysis of the relativity between the drug resistance and genotype of clinical strains isolated from tuberculous meningitis

目的 了解结核性脑膜炎（tuberculous meningitis,TBM）的致病菌在耐药性和基因型方面的相关性.方法 从500例疑似TBM患者脑脊液标本中经MGIT（Mycobacteria growth indicator tube）960培养仪分离培养出25株结核分枝杆菌（Mycobacterium tuberculosis,Mtb）,对这25株Mtb分别进行间隔区寡核苷酸分型（Spoligotyping）法基因分型、14种抗结核药物的药物敏感性试验、10个耐药基因测序.结果 20株为北京基因型,占80.0％（20/25）;耐多药结核性脑膜炎（MDR TBM）有3株（3/25）,都属于北京基因型;测序结果显示inhA、embB、gyrB、eis 基因未发生突变,katG、rpoB、gyrA、rrs-KAN、rpsL、gidB基因发生突变.结论 北京基因型在耐药TBM中所占比例高,尤其是MDR-TBM.耐药TBM临床分离株与相关耐药基因突变有关系.

Objective To study the relativity between the drug resistance and genotype of clinical strains isolated from tuberculous meningitis （TBM）.Methods M.tuberculosis was cultured and isolated in cerebrospinal fluids （CSF） from 25 cases diagnosed with TBM in Xijing Hospital.These isolates were performed the susceptibility testing of 14 antituberculosis drugs,the sequencing of 10 drug-resistant genes and strain typing by Spoligotyping.Results Of 2 5 M.tuberculosis isolates,20 （80.0 ％） clinical isolates were identified as Beijing genotype by Spoligotyping; 3 （3/25） strains were multidrug-resistant （MDR） and belonged to Beijing genotype,in which katG,rpoB,gyrA,rrs-KAN,rpsL,gidB genes were found the mutations,but inhA,embB,gyrB,eis genes had not mutation by the DNA sequencing.Conclusion Beijing genotype strains may act as the main epidemic strain of TBM,especially MDR TBM.