GeneXpert assay 对巴基斯坦开伯尔-普赫图赫瓦省治疗和未治疗的肺结核患者利福平耐药性的分子检测。

Molecular detection of rifampicin resistance by GeneXpert assay among treated and untreated pulmonary tuberculosis patients from Khyber Pakhtunkhwa, Pakistan.

机构信息

Department of Microbiology, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, Pakistan.

Department of Microbiology, Kohat University of Science and Technology, Kohat, Khyber Pakhtunkhwa, Pakistan.

出版信息

J Glob Antimicrob Resist. 2017 Jun;9:118-120. doi: 10.1016/j.jgar.2017.02.013. Epub 2017 May 10.

DOI:10.1016/j.jgar.2017.02.013

PMID:28501582

Abstract

OBJECTIVES

Drug-resistant tuberculosis (TB) is an emerging health problem. Rifampicin (RIF) is the major first-line drug against TB. RIF resistance can be used as a marker for the detection of multidrug-resistant TB (MDR-TB). The purpose of this study was to determine the RIF resistance pattern of Mycobacterium tuberculosis complex isolates among treated and untreated patients in Khyber Pakhtunkhwa, Pakistan.

METHODS

A total of 349 drug-treated and untreated TB-diagnosed patients were enrolled in this study. RIF resistance was detected using a GeneXpert assay for amplification of the RIF resistance-determining region (RRDR) region of the rpoB gene.

RESULTS

The overall prevalence of RIF resistance was 5.2% (18/349). Among 49 untreated TB patients, 3 samples (6.1%) were found resistant to RIF. Among 235 patients with a category 1 treatment regimen, 10 samples (4.3%) were resistant to RIF, whilst among 65 patients with a category 2 (Cat-2) treatment regimen, 5 samples (7.7%) were resistant to RIF. A comparison based on patient sex revealed high RIF resistance among male compared with female patients. RIF resistance was highest (4/21; 19.0%) in the 21-40 years age group among Cat-2 patients.

CONCLUSIONS

The overall prevalence of RIF resistance was high among treated and untreated TB patients. These findings will be helpful for better monitoring and management of RIF resistance in TB patients from Khyber Pakhtunkhwa, Pakistan.

摘要

目的

耐药结核病（TB）是一个新出现的健康问题。利福平（RIF）是治疗结核病的主要一线药物。RIF 耐药可作为检测耐多药结核病（MDR-TB）的标志物。本研究旨在确定巴基斯坦开伯尔-普赫图赫瓦省治疗和未治疗的结核病患者中结核分枝杆菌复合群分离株的 RIF 耐药模式。

方法

本研究共纳入 349 例接受药物治疗和未接受治疗的结核病患者。使用 GeneXpert 检测扩增 rpoB 基因的 RIF 耐药决定区（RRDR）区域来检测 RIF 耐药性。

结果

RIF 耐药的总体流行率为 5.2%（18/349）。在 49 例未治疗的结核病患者中，有 3 个样本（6.1%）对 RIF 耐药。在接受 1 类治疗方案的 235 例患者中，有 10 个样本（4.3%）对 RIF 耐药，而在接受 2 类（Cat-2）治疗方案的 65 例患者中，有 5 个样本（7.7%）对 RIF 耐药。基于患者性别进行比较显示，男性患者的 RIF 耐药率高于女性患者。Cat-2 患者中 21-40 岁年龄组的 RIF 耐药率最高（4/21；19.0%）。