Caws Maxine, Thwaites Guy, Stepniewska Kasia, Nguyen Thi Ngoc Lan, Nguyen Thi Hong Duyen, Nguyen Thi Phuong, Mai Nguyet Thu Huyen, Phan Minh Duy, Tran Huu Loc, Tran Thi Hong Chau, van Soolingen Dick, Kremer Kristin, Nguyen Van Vinh Chau, Nguyen Tran Chinh, Farrar Jeremy
Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, Quan 5, Ho Chi Minh City, Vietnam.
J Clin Microbiol. 2006 Nov;44(11):3934-9. doi: 10.1128/JCM.01181-06. Epub 2006 Sep 13.
Multidrug-resistant tuberculous meningitis is fatal without rapid diagnosis and use of second-line therapy. It is more common in human immunodeficiency virus (HIV)-positive patients. Beijing genotype strains of Mycobacterium tuberculosis are associated with drug resistance, particularly multidrug resistance, and their prevalence is increasing worldwide. The prevalence of Beijing genotype strains among Mycobacterium tuberculosis isolates from the cerebrospinal fluid of HIV-positive (n = 35) and HIV-negative (n = 187) patients in Ho Chi Minh City was determined. The Beijing genotype was significantly associated with HIV status (odds ratio [OR] = 2.95 [95% confidence interval {CI}, 1.38 to 6.44]; P = 0.016), resistance to any drug (OR = 3.34 [95% CI, 1.87 to 5.95]; P < 0.001) and multidrug resistance (Fisher's exact test; P = 0.001). The association of the Beijing genotype with drug resistance was independent of HIV status. This is the first report of Beijing genotype association with HIV status, which may be an association unique to tuberculous meningitis.
耐多药结核性脑膜炎若不迅速诊断并使用二线治疗则会致命。它在人类免疫缺陷病毒（HIV）阳性患者中更为常见。结核分枝杆菌的北京基因型菌株与耐药性相关，尤其是耐多药，并且其在全球的流行率正在上升。测定了胡志明市HIV阳性（n = 35）和HIV阴性（n = 187）患者脑脊液中结核分枝杆菌分离株的北京基因型菌株流行率。北京基因型与HIV状态显著相关（优势比[OR]=2.95[95%置信区间{CI}，1.38至6.44]；P = 0.016）、对任何药物的耐药性（OR = 3.34[95%CI，1.87至5.95]；P < 0.001）以及耐多药（Fisher精确检验；P = 0.001）。北京基因型与耐药性的关联独立于HIV状态。这是北京基因型与HIV状态关联的首次报告，这可能是结核性脑膜炎特有的一种关联。
