印度北部结核分枝杆菌分离株耐药的分子特征。

Molecular characterisation of drug resistance in Mycobacterium tuberculosis isolates from North India.

机构信息

Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Int J Tuberc Lung Dis. 2013 Feb;17(2):251-7. doi: 10.5588/ijtld.12.0319.

DOI:10.5588/ijtld.12.0319

PMID:23317963

Abstract

SETTING

A tertiary care hospital in North India.

OBJECTIVES

To analyse the frequency of mutations associated with resistance to rifampicin (RMP), isoniazid (INH) and streptomycin (SM) in Mycobacterium tuberculosis.

DESIGN

M. tuberculosis isolates from 171 pulmonary tuberculosis (TB) patients (newly diagnosed 102, 59.6%; retreated 69, 40.3%) were analysed. Drug susceptibility testing was performed using the proportion method and resistant isolates were characterised using the polymerase chain reaction, followed by restriction fragment length polymorphism and/or DNA sequencing, to screen for mutations in rpoB, katG, mabA-inhA and rpsL.

RESULTS

Of the 171 isolates, 16.9% (29/171) were multidrug-resistant. Of the 102 newly diagnosed and 69 retreated cases, respectively 5.9% (6/102) and 33.3% (23/69) were multidrug-resistant. rpoB mutations were found in 100% (31/31) of the RMP-resistant isolates, the most common being S531L in 74.2% (23/31); katG315 mutations were found in 79.6% (35/44) of the INH-resistant isolates; however, no mabA-inhA (-15) mutation was found; rpsL mutations were found in 48.9% (24/49) of the SM-resistant isolates, and codon 43 mutation were found in 42.5% (21/49).

CONCLUSIONS

This study characterises drug resistance-associated mutations in M. tuberculosis, information that could be used for the rapid screening of drug-resistant TB.

摘要

背景

印度北部的一家三级保健医院。

目的

分析与利福平（RMP）、异烟肼（INH）和链霉素（SM）耐药相关的结核分枝杆菌突变的频率。

设计

分析了来自 171 例肺结核（TB）患者（新诊断 102 例，59.6%；复治 69 例，40.3%）的结核分枝杆菌分离株。采用比例法进行药物敏感性试验，对耐药分离株采用聚合酶链反应（PCR），然后进行限制性片段长度多态性（RFLP）和/或 DNA 测序，以筛选 rpoB、katG、mabA-inhA 和 rpsL 中的突变。

结果

171 株分离株中，16.9%（29/171）为耐多药。在新诊断的 102 例和复治的 69 例中，分别有 5.9%（6/102）和 33.3%（23/69）为耐多药。在 100%（31/31）的 RMP 耐药分离株中发现 rpoB 突变，最常见的是 S531L，占 74.2%（23/31）；在 79.6%（35/44）的 INH 耐药分离株中发现 katG315 突变；然而，未发现 mabA-inhA（-15）突变；在 48.9%（24/49）的 SM 耐药分离株中发现 rpsL 突变，42.5%（21/49）发现 codon 43 突变。