在埃塞俄比亚提格雷地区进行的一项横断面研究中，从肺结核患者中分离出的结核分枝杆菌中，一线和二线耐药相关突变的频率和模式。
Frequency and patterns of first- and second-line drug resistance-conferring mutations in Mycobacterium tuberculosis isolated from pulmonary tuberculosis patients in a cross-sectional study in Tigray Region, Ethiopia.
机构信息
Department of Para Clinical Sciences, Norwegian University of Life Sciences, P.O. Box 369, 0102 Oslo, Norway; Department of Production Animal Medicine, Norwegian University of Life Sciences, P.O. Box 369, 0102 Oslo, Norway; Department of Medical Microbiology and Immunology, Division of Biomedical Sciences, College of Health Sciences, Mekelle University, P.O. Box 1871, Mekelle, Ethiopia.
Department of Production Animal Medicine, Norwegian University of Life Sciences, P.O. Box 369, 0102 Oslo, Norway.
出版信息
J Glob Antimicrob Resist. 2021 Mar;24:6-13. doi: 10.1016/j.jgar.2020.11.017. Epub 2020 Dec 3.
OBJECTIVES
Tuberculosis (TB) is a preventable and treatable infectious disease, but the continuing emergence and spread of multidrug-resistant TB is threatening global TB control efforts. This study aimed to describe the frequency and patterns of drug resistance-conferring mutations of Mycobacterium tuberculosis (MTB) isolates detected from pulmonary TB patients in Tigray Region, Ethiopia.
METHODS
A cross-sectional study design was employed to collect sputum samples from pulmonary TB patients between July 2018 to August 2019. Culture and identification tests were done at Tigray Health Research Institute (THRI). Mutations conferring rifampicin (RIF), isoniazid (INH) and fluoroquinolone (FQ) resistance were determined in 227 MTB isolates using GenoType MTBDRplus and GenoType MTBDRsl.
RESULTS
Mutations conferring resistance to RIF, INH and FQs were detected in 40/227 (17.6%), 41/227 (18.1%) and 2/38 (5.3%) MTB isolates, respectively. The majority of mutations for RIF, INH and FQs occurred at codons rpoB S531L (70%), katG S315T (78%) and gyrA D94Y/N (100%), respectively. This study revealed a significant number of unknown mutations in the rpoB, katG and inhA genes.
CONCLUSION
High rates of mutations conferring resistance to RIF, INH and FQs were observed in this study. A large number of isolates showed unknown mutations, which require further DNA sequencing analysis. Periodic drug resistance surveillance and scaling-up of drug resistance testing facilities are imperative to prevent the transmission of drug-resistant TB in the community.
目的
结核病（TB）是一种可预防和可治疗的传染病，但耐多药结核病（MDR-TB）的不断出现和传播正威胁着全球结核病控制工作。本研究旨在描述从埃塞俄比亚提格雷地区的肺结核患者中分离出的结核分枝杆菌（MTB）分离株的耐药相关突变的频率和模式。
方法
采用横断面研究设计，于 2018 年 7 月至 2019 年 8 月期间收集肺结核患者的痰液样本。在提格雷健康研究所（THRI）进行培养和鉴定试验。使用 GenoType MTBDRplus 和 GenoType MTBDRsl 确定 227 株 MTB 分离株中与利福平（RIF）、异烟肼（INH）和氟喹诺酮（FQ）耐药相关的突变。
结果
在 227 株 MTB 分离株中，分别检测到 40/227（17.6%）、41/227（18.1%）和 2/38（5.3%）株对 RIF、INH 和 FQ 耐药的突变。RIF、INH 和 FQ 的耐药相关突变主要发生在 rpoB S531L（70%）、katG S315T（78%）和 gyrA D94Y/N（100%）。本研究发现 rpoB、katG 和 inhA 基因中存在大量未知突变。
结论
本研究中观察到 RIF、INH 和 FQ 耐药相关突变的发生率较高。大量分离株显示未知突变，需要进一步进行 DNA 测序分析。定期进行耐药监测和扩大耐药检测设施是预防社区中传播耐药性结核病的必要措施。
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