Zhao Li-li, Chen Yan, Chen Zhong-nan, Liu Hai-can, Hu Pei-lei, Sun Qing, Zhao Xiu-qin, Jiang Yi, Li Gui-lian, Tan Yun-hong, Wan Kang-lin
National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention/State Key Laboratory for Infectious Disease Prevention and Control/National Reference Laboratory of Tuberculosis, Beijing, China Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China.
National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention/State Key Laboratory for Infectious Disease Prevention and Control/National Reference Laboratory of Tuberculosis, Beijing, China Pathogenic Biology Institute, University of South China, Hengyang, Hunan, China.
Antimicrob Agents Chemother. 2014 Jun;58(6):3475-80. doi: 10.1128/AAC.02426-14. Epub 2014 Apr 14.
To determine the prevalence and molecular characteristics of drug-resistant tuberculosis in Hunan province, drug susceptibility testing and spoligotyping methods were performed among 171 M. tuberculosis isolates. In addition, the mutated characteristics of 12 loci, including katG, inhA, rpoB, rpsL, nucleotides 388 to 1084 of the rrs gene [rrs(388-1084)], embB, pncA, tlyA, eis, nucleotides 1158 to 1674 of the rrs gene [rrs(1158-1674)], gyrA, and gyrB, among drug-resistant isolates were also analyzed by DNA sequencing. Our results indicated that the prevalences of isoniazid (INH), rifampin (RIF), streptomycin (SM), ethambutol (EMB), pyrazinamide (PZA), capreomycin (CAP), kanamycin (KAN), amikacin (AKM), and ofloxacin (OFX) resistance in Hunan province were 35.7%, 26.9%, 20.5%, 9.9% 15.2%, 2.3%, 1.8%, 1.2%, and 10.5%, respectively. The previously treated patients presented significantly increased risks for developing drug resistance. The majority of M. tuberculosis isolates belonged to the Beijing family. Almost all the drug resistance results demonstrated no association with genotype. The most frequent mutations of drug-resistant isolates were katG codon 315 (katG315), inhA15, rpoB531, rpoB526, rpoB516, rpsL43, rrs514, embB306, pncA96, rrs1401, gyrA94, and gyrA90. These results contribute to the knowledge of the prevalence of drug resistance in Hunan province and also expand the molecular characteristics of drug resistance in China.
为确定湖南省耐药结核病的流行情况及分子特征，对171株结核分枝杆菌分离株进行了药敏试验和间隔寡核苷酸分型（spoligotyping）。此外，还通过DNA测序分析了耐药分离株中12个位点的突变特征，包括katG、inhA、rpoB、rpsL、rrs基因388至1084位核苷酸[rrs(388 - 1084)]、embB、pncA、tlyA、eis、rrs基因1158至1674位核苷酸[rrs(1158 - 1674)]、gyrA和gyrB。我们的结果表明，湖南省异烟肼（INH）、利福平（RIF）、链霉素（SM）、乙胺丁醇（EMB）、吡嗪酰胺（PZA）、卷曲霉素（CAP）、卡那霉素（KAN）、阿米卡星（AKM）和氧氟沙星（OFX）的耐药率分别为35.7%、26.9%、20.5%、9.9%、15.2%、2.3%、1.8%、1.2%和10.5%。既往接受过治疗的患者出现耐药的风险显著增加。大多数结核分枝杆菌分离株属于北京家族。几乎所有耐药结果均显示与基因型无关联。耐药分离株最常见的突变是katG密码子315（katG315）、inhA15、rpoB531、rpoB526、rpoB516、rpsL43、rrs514、embB306、pncA96、rrs1401、gyrA94和gyrA90。这些结果有助于了解湖南省耐药情况，也扩展了中国耐药的分子特征。
