Thakur C, Kumar V, Gupta A K
Intermediate Reference Laboratory, Government Tuberculosis Sanatorium, Dharampur, Solan, Himachal Pradesh, India.
Indian J Med Microbiol. 2015 Oct-Dec;33(4):547-53. doi: 10.4103/0255-0857.167336.
Tuberculosis (TB) is a major public health problem in India and a principal cause of death in adults, especially among the economically productive age group. India accounts for one-fifth of the global burden of TB. It is estimated that about 40% of Indian population is infected with TB bacillus. The GenoType® MTBDRplus molecular method allows rapid diagnosis of the clinical samples and detection of the most common mutations in the genes associated with rifampicin (R) and isoniazid (H) resistance.
To study the drug resistance and mutational patterns in multidrug-resistant (MDR) suspects clinical strains using GenoType® MTBDRplus assay.
A total of 770 sputum samples of the MDR-TB suspects were included in this study, which were received at Intermediate Reference Laboratory, Government TB Sanatorium, Dharampur, Solan, Himachal Pradesh from the Designated Microscopy Centres of Himachal Pradesh for the culture and susceptibility testing. All the 521 Mycobacterium tuberculosis complex (MTBC) strains were subjected to GenoType® MTBDRplus (HAIN Lifescience) assay to detect molecular resistance pattern to first line anti-tubercular drugs (isoniazid and rifampicin).
Of 770 samples, 556 (72.20%) were from male and 214 (27.80%) were from female. Among the 521 MTBC strains, 19.76% were found to be MDR and mono-resistance to isoniazid and rifampicin was detected in 8.63% and 6.14% strains respectively. About 74.81%, 76.35% and 5.40% strains harboured known mutation in rpoB, katG and inhA genes respectively.
In rpoB gene, the most common mutation is associated with S531 L region. The GenoType® MTBDRplus assay is a rapid test for the detection of the most common mutations in MDR-TB strains. In our study, unknown rpoB gene mutations were found in 25.18% strains that may further be detected by gene sequencing.
结核病是印度的一个主要公共卫生问题，也是成年人死亡的主要原因，尤其是在经济上具有生产能力的年龄组中。印度占全球结核病负担的五分之一。据估计，约40%的印度人口感染了结核杆菌。GenoType® MTBDRplus分子方法可对临床样本进行快速诊断，并检测与利福平（R）和异烟肼（H）耐药相关基因中最常见的突变。
使用GenoType® MTBDRplus检测法研究耐多药（MDR）疑似临床菌株的耐药性和突变模式。
本研究共纳入770份耐多药结核病疑似患者的痰液样本，这些样本由喜马偕尔邦指定显微镜中心送至喜马偕尔邦索兰县达兰布尔政府结核病疗养院的中间参考实验室进行培养和药敏试验。所有521株结核分枝杆菌复合群（MTBC）菌株均采用GenoType® MTBDRplus（海因生命科学公司）检测法，以检测对一线抗结核药物（异烟肼和利福平）的分子耐药模式。
770份样本中，556份（72.20%）来自男性，214份（27.80%）来自女性。在521株MTBC菌株中，19.76%被发现为耐多药，分别有8.63%和6.14%的菌株检测出对异烟肼和利福平单耐药。分别约有74.81%、76.35%和5.40%的菌株在rpoB、katG和inhA基因中存在已知突变。
在rpoB基因中，最常见的突变与S531L区域相关。GenoType® MTBDRplus检测法是检测耐多药结核菌株中最常见突变的快速检测方法。在我们的研究中，25.18%的菌株中发现了未知的rpoB基因突变，可能需要通过基因测序进一步检测。
