Center for Disease Control and Prevention of Wuzhong District, Suzhou, Jiangsu Province, PR China; Department of Epidemiology and Statistics, School of Public Health, Southeast University, Nanjing, Jiangsu Province, PR China.
The Fourth Hospital of Lianyungang City, Lianyungang, Jiangsu Province, PR China.
J Glob Antimicrob Resist. 2022 Sep;30:335-339. doi: 10.1016/j.jgar.2022.07.003. Epub 2022 Jul 8.
Isoniazid resistance might be overlooked because of the priority of detection of rifampicin-resistant tuberculosis. It was urgent to reveal the current situation of isoniazid-resistant tuberculosis (HR-TB), including unfavorable outcomes and bacterial factors.
A retrospective cohort study was undertaken including 120 patients with HR-TB and 193 patients with drug-sensitive tuberculosis (DS-TB). 24-loci MIRU-VNTR and Spoligotyping were adopted for genotyping.
We found 106 cases (88.3%) of HR-TB and 165 cases (85.5%) of DS-TB were treated with the first-line drugs. Meanwhile, 12 (10.0%) patients of the HR-TB group and 7 (3.63%) patients of the DS-TB group involved adverse treatment outcomes (χ = 5.271, P = 0.028). Seventy-eight DNA from HR Mycobacterium tuberculosis and 114 DNA from DS M. tuberculosis were available for MIRU-VNTR and Spoligotyping. The clustering rate was 17.9% (14/78) for HR-TB and 16.7% (19/114) for DS-TB, and reached no significant difference (χ = 0.05, P = 0.8171). The Beijing family strains accounted for 83.7% (65/78) of HR-TB and 80.0% (91/114) of DS-TB (χ = 0.37, P = 0.5407). The adverse treatment outcomes for HR-TB all occurred in patients infected with Beijing family strains (13.8%), but no difference was found between Beijing and non-Beijing genotypes (P = 0.342).
Adverse outcomes were significantly more frequent in patients with HR-TB than in those with DS-TB, and most of the patients with HR-TB were receiving a standard first-line regimen. Although the clustering rate and Beijing genotype distribution amongst HR-TB and DS-TB showed no significant difference, the Beijing genotype was the dominant genotype and its proportion was slightly higher amongst HR-TB than amongst DS-TB.
由于优先检测利福平耐药结核，异烟肼耐药可能被忽视。揭示异烟肼耐药结核（HR-TB）的现状，包括不良结局和细菌因素，这是当务之急。
回顾性队列研究纳入了 120 例 HR-TB 患者和 193 例药敏结核（DS-TB）患者。采用 24 位基因 MIRU-VNTR 和 spoligotyping 进行基因分型。
我们发现 106 例（88.3%）HR-TB 和 165 例（85.5%）DS-TB 患者接受了一线药物治疗。同时，HR-TB 组 12 例（10.0%）和 DS-TB 组 7 例（3.63%）患者出现不良治疗结局（χ2=5.271，P=0.028）。HR 结核分枝杆菌 78 株和 DS 结核分枝杆菌 114 株的 DNA 可用于 MIRU-VNTR 和 spoligotyping。HR-TB 的聚类率为 17.9%（14/78），DS-TB 为 16.7%（19/114），无显著性差异（χ2=0.05，P=0.8171）。北京家族株占 HR-TB 的 83.7%（65/78）和 DS-TB 的 80.0%（91/114）（χ2=0.37，P=0.5407）。HR-TB 的不良治疗结局均发生在感染北京家族株的患者中（13.8%），但北京株和非北京株基因型之间无差异（P=0.342）。
HR-TB 患者的不良结局发生率明显高于 DS-TB 患者，且大多数 HR-TB 患者正在接受标准一线方案治疗。尽管 HR-TB 和 DS-TB 的聚类率和北京基因型分布无显著差异，但北京基因型是主要基因型，其在 HR-TB 中的比例略高于 DS-TB。
