摘要
目的了解海盐县分离自肺结核病人的结核分枝杆菌耐药基因突变率及耐药情况,以利抗结核治疗中抗菌药物的合理选用。方法对痰涂片阳性的新发初治和复治肺结核病人进行痰结核分枝杆菌培养,阳性菌株采用高、低两种药物浓度,四种抗结核药物耐药性测试,同时用实时PCR法对结核分枝杆菌的耐药基因rpoB和katG突变进行检测。结果131例痰培养阳性菌株总耐药率为14.5%,其中初治耐药率7.8%,复治耐药率38.2%,对四种抗结核药物的耐药率依次为异烟肼9.2%,利福平4.6%,链霉素4.6%,乙胺丁醇0.8%。耐药基因检测结果,在初治组中rpoB和katG的突变率为12.7%(13/102)和10.8%(11/102)。复治组中rpoB和katG的突变率为31.0%(9/29)和20.7%(6/29)。结论本地区分离自结核病人的结核分枝杆菌在初始治疗时已存在耐药性,而药物治疗有可能使其耐药性增加。结果表明抗结核治疗前及在治疗过程中对结核分枝杆菌进行耐药性及耐药基因检测很有意义。
Objective To understand the antimicrobial-resistance and the mutations of resistant genes of clinical Mycobacterium tuberculosis isolates in Haiyan area,and to help carrying out the therapy of infection. Methods The new patients with the positive in smears of sputum and the re-therapy pulmonary tuberculosis patients were detected as Mycobacterium tuberculosis by sputum culture. The antimicrobial-resistance of isolates was detected by high and low concentration of antimicrobial agents method. The resistant-genes mutations of rpoB ane katG genes were detected by a real-time PCR. Results Among 131 strains of clinical Mycobacterium tuberculosis isolates , the total antimicrobial-resistance rate was 14.5%, while 7.8% in the new patients and 38.2% in the re-therapy patients. The mutations of rpoB ane katG genes were 12.7% and 10.8% in the new patients, but 31.0% and 20.7% in the re-therapy patients. Conclusion The drug-resistance of Mycobacterium tuberculosis isolates in this area had existed before therapy of anti-infection, and it could be increasing during the therapy. It is important to detect the resistance and the resistance-genes mutations of the isolates before and after the anti-infection.
出处
《浙江检验医学》
2006年第4期9-11,共3页
Zhejiang Journal of Laboratory Medicine
关键词
结核分枝杆菌
耐药
耐药基因
实时PCR
Mycobacterium tuberculosis
Antimicrobial-resistance
Resistance-genes
Real-time-PCR
