株洲地区北京基因型结核分枝杆菌感染与利福平耐药的相关研究

Correlative research between Beijing genotypes MTB infection in Zhuzhou and rifampin resistance

目的研究北京基因型结核分枝杆菌(MTB)感染的易感因素及其与利福平耐药的相关性。方法收集株洲市2014年5月至2016年8月痰抗酸染色阳性肺结核患者156例痰标本,对MTB进行分离培养与菌种鉴定。培养阳性菌株行DNA提取,运用RD105缺失基因检测法鉴定北京基因型MTB、Xpert MTB/RIF检测法鉴定耐利福平MTB,分析性别、年龄、糖尿病、复治患者以及利福平耐药与北京基因型的关系。结果156例痰标本中培养出分枝杆菌150株,其中MTB菌株142株,非MTB菌株8株。女性患者的北京基因型MTB(38/68,55.8%)的比例明显高于男性患者(13/74,17.5%),复治患者北京基因型MTB(26/55,47.2%)比例明显高于初治患者(18/87,20.6%),糖尿病患者北京基因型MTB(32/61,52.4%)比例明显高于非糖尿病患者北京基因型MTB(19/81,23.4%),年龄≥55岁的患者北京基因型MTB(31/60,51.6%)明显高于年龄≤30岁的患者(4/30,13.3%),差异均有统计学意义(P<0.05)。在耐利福平菌株中北京基因型MTB(40/48,83.3%)明显高于非耐利福平菌株中北京基因型MTB(11/94,11.7%),差异有统计学意义(P<0.05)。结论女性、高龄、并发糖尿病、复治,可能是感染北京基因型MTB的危险因素。北京基因型MTB与利福平耐药有明显相关性。

Objective To explore the correlation between Beijing genotypes MTB infection in Zhuzhou and rifampin resistance.Methods 156 sputum specimens of tuberculosis with positive sputum anti-acid stain were collected from May 2014 to August 2016 in Zhuzhou, and they were given isolated culture and strain identification.The positive strains were given DNA extract, and Beijing genotypes MTB was identified by RD105 missing genetic test and rifampin resistance of MTB by Xpert MTB/test so as to analyze the association of Beijing genotypes with gender, age, diabetes, retreatment patients and rifampin resistance.Results 150 mycobacterium were cultivated among 156 sputum specimens, wherein there were 142 MTB strains and 8 non-MTB strains.The proportion of Beijing genotypes MTB of female patients （38/68, 55.8%） was apparently higher than that of male patients （13/74, 17.5%）, and the proportion of Beijing genotypes MTB of retreated patients （26/55, 47.2%） was apparently higher than that of untreated patients （18/87, 20.6%）, and the proportion of Beijing genotypes MTB of diabetes patients （32/61,52.4%） was apparently higher than that of non-diabetes patients （19/81, 23.4%）, and the proportion of Beijing genotypes MTB of patients over 55 years old （31/60, 51.6%） was apparently higher than that of patients below 30 （4/30, 13.3%） （P〈0.05）.Beijing genotypes MTB in rifampin-resistance strains （40/48, 83.3%） was obviously higher than that in non-rifampin resistance strains （11/94, 11.7%） （P〈0.05）.Conclusion Female, advanced age, diabetes and retreatment might be the risk factors of Beijing genotypes MTB infection.Beijing genotypes MTB is obviously associated with rifampin resistance.