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采用直接重复序列的分子分型方法评估肺结核病例中结核分枝杆菌临床分离株的耐药模式和基因特征。

Assess drug resistance pattern and genetic profile of Mycobacterium tuberculosis clinical isolates by molecular typing methods using direct repeats and in pulmonary tuberculosis cases.

作者信息

Kalo Deepika, Kant Surya, Srivastava Kanchan, Sharma Ajay K

机构信息

Department of Zoology, University of Lucknow, Lucknow, Uttar Pradesh, India.

Department of Respiratory Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.

出版信息

Lung India. 2017 Mar-Apr;34(2):155-159. doi: 10.4103/0970-2113.201314.

DOI:10.4103/0970-2113.201314
PMID:28360464
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5351358/
Abstract

BACKGROUND

Tuberculosis (TB), a highly contagious disease that sees no gender, age, or race is mainly a disease of lungs. According to World Health Organization, a TB patient can be completely cured with 6-9 months of anti-TB treatment under directly observed treatment short course.

OBJECTIVES

The aim of this study was to check the mono, multi- and triple-drug resistance to first line drugs (FLDs) among TB patients and to access their genetic profile using DR 3074, DR 0270, DR 0642, DR 2068, and DR 4110 using molecular techniques.

MATERIAL AND METHODS

To gain a better understanding of drug resistant TB, we characterized 121 clinical isolates recovered from 159 drug resistant pulmonary tuberculosis patients by genotyping. MTB isolates recovered from HIV- negative, and smear positive cases of both genders, age varied from 18 to 70 years with drug resistant-TB that was refractory to chemotherapy given for > 12 months. Of a total of 159 sputum smear positive patients sum number of male and female patients was 121 (76.10%) and 38 (23.89%), respectively. Among these patients, number of literate and illiterate patients were 123 (77.3%) and 36 (22.6%). 25 (15.7%) patients had farming as their occupation, 80 (50.3%) had nonagricultural occupation and 54 (33.9%) women were housewives.

RESULTS

Mono drug resistant, multi-drug resistant, and totally drug resistant (TDR) cases of TB were calculated as 113.83%, 125.1%, and 67.9%. Isoniazid showed the highest percentage of resistance among the patients.

CONCLUSION

Any noncompliance to TB medications, lack of knowledge, and poor management in health centers, etc., results in the emergence of deadly direct repeat forms of TB, which are further complicated and complex to treat.

摘要

背景

结核病(TB)是一种高度传染性疾病,不分性别、年龄或种族,主要是肺部疾病。根据世界卫生组织的说法,在直接观察下的短程治疗中,结核病患者通过6至9个月的抗结核治疗可以完全治愈。

目的

本研究的目的是检查结核病患者对一线药物(FLDs)的单药、多药和三联耐药情况,并使用分子技术通过DR 3074、DR 0270、DR 0642、DR 2068和DR 4110分析其基因特征。

材料与方法

为了更好地了解耐药结核病,我们通过基因分型对从159例耐药性肺结核患者中分离出的121株临床菌株进行了特征分析。结核分枝杆菌分离株来自HIV阴性、涂片阳性的男女患者,年龄在18至70岁之间,患有耐药结核病,对超过12个月的化疗无效。在总共159例痰涂片阳性患者中,男性和女性患者总数分别为121例(76.10%)和38例(23.89%)。在这些患者中,识字和不识字的患者人数分别为123例(77.3%)和36例(22.6%)。25例(15.7%)患者以务农为职业,80例(50.3%)从事非农业职业,54例(33.9%)女性为家庭主妇。

结果

结核病的单药耐药、多药耐药和完全耐药(TDR)病例分别计算为113.83%、125.1%和67.9%。异烟肼在患者中的耐药率最高。

结论

任何对结核病药物的不依从、知识缺乏以及医疗中心管理不善等,都会导致致命的直接重复型结核病的出现,而这种类型的结核病治疗起来更加复杂和困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b46/5351358/9dfe5a780ccb/LI-34-155-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b46/5351358/ff6a7b9b052c/LI-34-155-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b46/5351358/7b83cd66a869/LI-34-155-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b46/5351358/9dfe5a780ccb/LI-34-155-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b46/5351358/ff6a7b9b052c/LI-34-155-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b46/5351358/7b83cd66a869/LI-34-155-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b46/5351358/9dfe5a780ccb/LI-34-155-g011.jpg

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本文引用的文献

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Multidrug resistant tuberculosis: trends and control.耐多药结核病:趋势与防控
Indian J Chest Dis Allied Sci. 2014 Oct-Dec;56(4):237-46.
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Risk factors and drug-resistance patterns among pulmonary tuberculosis patients in northern Karnataka region, India.印度卡纳塔克邦北部地区肺结核患者的风险因素及耐药模式
Niger Med J. 2014 Jul;55(4):327-32. doi: 10.4103/0300-1652.137194.
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Prevalence of multidrug resistance among retreatment pulmonary tuberculosis cases in a tertiary care hospital, Hyderabad, India.印度海得拉巴市一家三级护理医院复治肺结核病例中的多重耐药率
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Initial drug resistance pattern among pulmonary tuberculosis patients.肺结核患者的初始耐药模式。
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Drug resistance profiles of Mycobacterium tuberculosis isolates to first line anti-tuberculous drugs: A five years study.结核分枝杆菌分离株对一线抗结核药物的耐药谱:一项五年研究。
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Latent tuberculosis: what the host "sees"?潜伏性结核:宿主“所见”为何?
Immunol Res. 2011 Aug;50(2-3):202-12. doi: 10.1007/s12026-011-8229-7.
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Natural history of tuberculosis: duration and fatality of untreated pulmonary tuberculosis in HIV negative patients: a systematic review.结核病自然史:HIV 阴性患者未经治疗的肺结核的持续时间和死亡率:系统评价。
PLoS One. 2011 Apr 4;6(4):e17601. doi: 10.1371/journal.pone.0017601.
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A novel identification scheme for genus Mycobacterium, M. tuberculosis complex, and seven mycobacteria species of human clinical impact.一种针对分枝杆菌属、结核分枝杆菌复合群以及七种对人类临床有影响的分枝杆菌物种的新型鉴定方案。
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Novel genetic polymorphisms that further delineate the phylogeny of the Mycobacterium tuberculosis complex.进一步描绘结核分枝杆菌复合群系统发育的新型基因多态性。
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