Dewi Desak Nyoman Surya Suameitria, Mertaniasih Ni Made
Doctoral Program of Medical Science, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya 60131, Indonesia.
Department of Medical Microbiology, Faculty of Medicine, Universitas Airlangga, Jl. Mayjen. Prof. Dr. Moestopo No. 47, Surabaya 60131, Indonesia.
Afr J Infect Dis. 2020 Jan 8;14(1):8-15. doi: 10.21010/ajid.v14i1.2. eCollection 2020.
The severity of pulmonary TB and detection of multidrug-resistant (MDR-TB) TB strains as potential causative agents could be crucial for the determination of treatment success. This study aimed to analyze the association between the specific sequences of the full esxA gene from MDR-TB sputum isolates and the severity class of MDR-TB patients.
A total of 98 sputum samples that were suspected to be MDR-TB were collected from Dr. Soetomo, Surabaya, Indonesia, from September to December 2016. A total of 24 isolates from the 98 patients were confirmed to have positive MDR-TB based on the GeneXpert test. MDR-TB isolates were tested using PCR targeting 580 bp encompassing the full esxA gene, and the resulting amplicon was sequenced. The severity class of the pulmonary TB patients was assessed using modified Bandim TB scoring.
The patient severity classification resulted in a moderate and severe degree of TB in 38% and a mild degree of TB in 63% of patients. Visualization of the PCR results showed that all MDR-TB samples were positive for the 580 bp band, and the sequence results showed 100% homology with that of the virulent wild-type H37Rv (NC_000962.3).
In the current study, an association between the characteristics of the full esxA gene and the severity class of MDR-TB patients is yet to be found. However, the homologous sequence of all samples, associated with various degrees of disease severity, possess 100% identity with that of wild-type H37Rv.
肺结核的严重程度以及检测耐多药（MDR-TB）结核菌株作为潜在病原体对于确定治疗成功与否可能至关重要。本研究旨在分析耐多药肺结核痰分离株中esxA基因全长的特定序列与耐多药肺结核患者严重程度分级之间的关联。
2016年9月至12月，从印度尼西亚泗水的苏托莫博士医院收集了总共98份疑似耐多药肺结核的痰标本。基于GeneXpert检测，98例患者中的24株分离株被确认为耐多药肺结核阳性。使用针对包含esxA基因全长的580 bp的PCR对耐多药肺结核分离株进行检测，并对所得扩增子进行测序。采用改良的班迪姆结核病评分法评估肺结核患者的严重程度分级。
患者严重程度分级结果显示，38%的患者为中度和重度肺结核，63%的患者为轻度肺结核。PCR结果可视化显示，所有耐多药肺结核样本的580 bp条带均为阳性，序列结果显示与强毒野生型H37Rv（NC_000962.3）的序列具有100%的同源性。
在本研究中，尚未发现esxA基因全长特征与耐多药肺结核患者严重程度分级之间的关联。然而，所有样本的同源序列，无论疾病严重程度如何，均与野生型H37Rv的序列具有100%的一致性。
