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巴西南部结核分枝杆菌菌株的耐药性。

Drug resistance of Mycobacterium tuberculosis strains in southern Brazil.

机构信息

Departamento de Ciências Farmacêuticas, Universidade de Blumenau, Blumenau, SC.

出版信息

Rev Soc Bras Med Trop. 2012 Feb;45(1):95-9. doi: 10.1590/s0037-86822012000100018.

Abstract

INTRODUCTION

The aim of this work was to evaluate the prevalence of Mycobacterium tuberculosis (MT) strains with mutations that could result in resistance to the main drugs used in treatment in a region with one of the highest numbers of tuberculosis (TB) cases in southern Brazil.

METHODS

Deoxyribonucleic acid (DNA) from 120 sputum samples from different patients suspicious of pulmonary tuberculosis who attended the Municipal Public Laboratory for Mycobacterium sp. diagnosis was directly amplified and analyzed by PCR-SSCP. The DNA was amplified in known hotspot mutation regions of the genes rpoB, ahpC, embB, katG, inhA, and pncA.

RESULTS

The percentage of samples positive by culture was 9.2% (11/120); 5% (6/120) were positive by bacilloscopy and MT-PCR, and DNA fragments of the aforementioned resistance genes could be amplified from seven (7) of the eleven (11) samples with positive results, either by culture or PCR/bacilloscopy. All presented a SSCP pattern similar to a native, nonresistant genotype, with the ATCC strain 25177 as control, except for one sample (0.01%), which presented a SSCP profile demonstrating mutation at the embB gene.

CONCLUSIONS

These results are consistent with the empirical observations by physicians treating TB patients in our region of a low occurrence of cases that are refractory to conventional treatment schemes, in contrast to other parts of the country. Continued surveillance, especially molecular, is essential to detect and monitor the outbreak of MT-resistant strains.

摘要

简介

本研究旨在评估巴西南部一个结核病(TB)病例最多的地区中,主要治疗药物耐药的结核分枝杆菌(MT)菌株的流行率。

方法

对 120 例不同疑似肺结核患者的痰液样本的 DNA 进行直接扩增,并通过 PCR-SSCP 进行分析。该 DNA 是在 rpoB、ahpC、embB、katG、inhA 和 pncA 基因的已知热点突变区域中扩增的。

结果

培养阳性率为 9.2%(11/120);5%(6/120)通过细菌镜检和 MT-PCR 阳性,从 11 个培养阳性或 PCR/细菌镜检阳性的样本中扩增出上述耐药基因的 DNA 片段。所有样本的 SSCP 图谱与野生型非耐药基因型相似,以 ATCC 25177 株作为对照,除了一个样本(0.01%)在 embB 基因中显示突变。

结论

这些结果与我们地区的医生治疗 TB 患者的经验观察一致,即对常规治疗方案耐药的病例发生率较低,与该国其他地区形成对比。持续监测,特别是分子监测,对于检测和监测 MT 耐药株的爆发至关重要。

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