Tripathi Rajneesh, Anupurba Shampa
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Indian J Pathol Microbiol. 2017 Apr-Jun;60(2):239-242. doi: 10.4103/IJPM.IJPM_53_16.
Detection of drug resistance in Mycobacterium tuberculosis by conventional phenotypic drug susceptibility testing methods requires several weeks. Therefore, molecular diagnostic tests for rapid detection of multidrug resistance tuberculosis (MDR-TB) are urgently needed. Early diagnosis helps in initiating optimal treatment which would not only enable cure of an individual patient but also will curb the transmission of drug resistance in the community. Line probe assay (LPA) has shown great promises in the diagnosis of MDR-TB. All MDR suspect patients from ten-linked districts were asked to deposit sputum samples at peripheral designated microscopy centers. The district TB officers facilitated the transport of samples collected during February 2014-December 2014 to our laboratory. The detection of rpoB gene mutations for rifampicin (RIF) and katG and inhA genes for isoniazid (INH), respectively, was performed on 663 samples by LPA. A total of 663 sputum samples from MDR suspects were received of which 321 (50.8%) were found to be MDR. Missing of WT8 along with mutation in codon S531 L was the most common pattern for RIF-resistant isolates (80.8%) and missing WT along with mutation in codon S315T1 of k atG gene was the most common pattern for INH-resistant isolates (91.3%).The MDR-TB in Eastern Uttar Pradesh, India, was found to be 50.8%. The common mutations obtained for RIF and INH in the region was mostly similar to those reported earlier.
采用传统表型药敏试验方法检测结核分枝杆菌的耐药性需要数周时间。因此,迫切需要用于快速检测耐多药结核病(MDR-TB)的分子诊断试验。早期诊断有助于启动最佳治疗,这不仅能治愈个体患者,还能遏制社区内耐药性的传播。线性探针分析(LPA)在MDR-TB的诊断中显示出巨大潜力。来自十个关联地区的所有耐多药疑似患者均被要求在周边指定的显微镜检查中心留存痰标本。地区结核病官员协助将2014年2月至2014年12月期间采集的样本运至我们的实验室。通过LPA对663份样本分别进行了利福平(RIF)的rpoB基因突变检测以及异烟肼(INH)的katG和inhA基因突变检测。共收到663份耐多药疑似患者的痰标本,其中321份(50.8%)被发现为耐多药。RIF耐药菌株最常见的模式是缺失WT8以及密码子S531L突变(80.8%),而INH耐药菌株最常见的模式是缺失WT以及katG基因密码子S315T1突变(91.3%)。印度北方邦东部的耐多药结核病患病率为50.8%该地区RIF和INH常见的突变大多与先前报道的相似。