台州地区结核分枝杆菌利福平和异烟肼耐药基因的流行病学调查

Epidemiological investigation of resistance genes of rifampicin and isoniazid of Mycobacterium tuberculosis in Taizhou area

目的了解台州地区临床流行的结核分枝杆菌利福平和异烟肼耐药基因的表型,为临床有效地治疗结核病提供依据。方法回顾性分析2015年8月至2020年11月送检于台州恩泽医疗中心(集团)恩泽医院的482株临床分离的结核分枝杆菌菌株,采用DNA微阵列芯片法对利福平耐药相关基因rpoB、异烟肼耐药相关基因katG及inhA基因进行特异性检测。结果482例结核分枝杆菌中利福平耐药基因检测出rpoB野生型367例,突变型115例,其中突变型以rpoB531(C→T)突变为主,检出55例;检出异烟肼耐药基因katG和inhA基因型均为野生型的372例,突变型110例,katG基因突变型中katG315(G→C)突变和katG315(G→A)突变分别是91例和12例,inhA基因突变型只有inhA-15(C→T)突变16例。2020年利福平基因耐药率增加到38.46%,异烟肼基因耐药率在6年间没有明显增长。结论台州地区结核分枝杆菌利福平和异烟肼耐药基因型以野生型为主,但利福平基因耐药率呈上升趋势。

Objective To understand the phenotype of resistance genes of rifampicin and isoniazid of Mycobacterium tuberculosis prevalent in Taizhou area,and to provide evidence for effective treatment of tuberculosis.Methods A total of 482 clinical isolates of Mycobacterium tuberculosis strains sent to and examined in Enze Hospital of Taizhou Enze Medical Center(Group)from August 2015 to November 2020 were analyzed retrospectively.Rifampicin resistance related gene in rpoB,isoniazid resistance related genes in katG and inhA were detected in specificity by DNA microarray chip method.Results In 482 cases of Mycobacterium tuberculosis,367 cases of rpoB wild type and 115 cases of rpoB mutation-type were detected in rifampicin resistance gene,in which rpoB531(C→T)mutation was the main mutation-type,and 55 cases were detected.372 cases of katG and InhA wild-type and 110 cases of mutation-type were detected in isoniazid resistance gene.In katG gene mutants,91 cases were katG315(G→C)mutation and 12 cases were katG315(G→A)mutation.There were only 16 cases of inhA-15(C→T)mutation in inhA gene mutants.In 2020,the resistance rate of rifampicin gene increased to 38.46%,while the resistance rate of isoniazid gene did not increase significantly for 6 years.Conclusion The resistant genotypes of rifampicin and isoniazid of Mycobacterium tuberculosis in Taizhou area is mainly the wild type,but the resistance rate of rifampicin gene is on the rise.