Xu Peng, Wu Jie, Yang Chongguang, Luo Tao, Shen Xin, Zhang Yangyi, Nsofor Chijioke A, Zhu Guofeng, Gicquel Brigitte, Gao Qian
Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Institute of Biomedical Sciences, Institute of Medical Microbiology, Shanghai Medical College, Fudan University, 138 Yi Xue Yuan Road, Shanghai 200032, China.
Department of Tuberculosis Control, Shanghai Municipal Center for Disease Control and Prevention, 1380 West Zhong Shan Road, Shanghai 200336, China.
Tuberculosis (Edinb). 2016 May;98:56-61. doi: 10.1016/j.tube.2016.02.008. Epub 2016 Mar 3.
Pyrazinamide (PZA) is an important first-line anti-tuberculosis drug, however, there are relatively few available data on PZA resistant (PZA-R) rate in China. From June 2009 to June 2012, we selected 493 isolates from five field settings in China to investigate PZA-R by pncA gene sequencing. The result showed that PZA-R rate was 1.0% (2/196) among pan-susceptible isolates, 3.1% (4/130) among isoniazid (INH) mono-resistant isolates, 14.0% (6/43) among rifampin (RIF) mono-resistant isolates and 43.5% (54/124) among multidrug resistant (MDR) isolates. MDR tuberculosis (TB), RIF mono-resistance, and retreatment were found to be risk factors for PZA-R. Newly diagnosed PZA-R TB patients and clustered isolates with identical pncA mutations indicate that transmission of PZA-R isolates plays an important role in emergence of PZA-R TB. The results suggest that, it is necessary to conduct PZA susceptibility test among MDR isolates and modify the treatment regimens accordingly.
吡嗪酰胺（PZA）是一种重要的一线抗结核药物，然而，中国关于吡嗪酰胺耐药（PZA-R）率的可用数据相对较少。2009年6月至2012年6月，我们从中国五个现场地点选取了493株分离株，通过pncA基因测序来调查PZA-R情况。结果显示，在全敏感分离株中PZA-R率为1.0%（2/196），在异烟肼（INH）单耐药分离株中为3.1%（4/130），在利福平（RIF）单耐药分离株中为14.0%（6/43），在耐多药（MDR）分离株中为43.5%（54/124）。耐多药结核病（TB）、利福平单耐药和复治被发现是PZA-R的危险因素。新诊断的PZA-R结核病患者以及具有相同pncA突变的聚集性分离株表明，PZA-R分离株的传播在PZA-R结核病的出现中起重要作用。结果表明，有必要对MDR分离株进行PZA药敏试验并相应调整治疗方案。
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