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结核病耐药性和分子检测方法在不同菌根结核病血统之间的比较研究

Chuan-Jiang He^1,2, Jiang-Li Wan², Sheng-Fang Luo²

¹Department of Laboratory Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China.

Infection and drug resistance

|September 13, 2023

概括

耐药性在Mycobacterium结核病血统之间有所不同,其中2个血统显示出更高的比率. 全基因组测序 (WGS) 可以准确检测耐药性,有助于临床决策.

科学领域:

微生物学微生物学
基因组学就是基因组学.
传染性疾病传染性疾病

背景情况:

结核病 (TB) 仍然是一个全球卫生挑战,由Mycobacterium tuberculosis (M.tb) 驱动.
在M.tb中耐药性使治疗复杂化,需要准确的诊断方法.
了解血统特定的耐药性模式对于有效的结核病控制至关重要.

研究的目的:

为了比较不同M.tb血统的药物耐药性概况.
评估表型药物敏感性测试 (pDST),高分辨率化 (HRM) 分析和全基因组测序 (WGS) 的诊断准确性,以检测对关键抗结核病药物的耐药性.
为改善分子诊断和有针对性的治疗策略提供见解.

主要方法:

现型药物敏感性测试 (pDST) 在161个M.tb菌株上进行.
使用高分辨率化 (HRM) 分析检测与药物耐药性相关的特定突变.
全基因组测序 (WGS) 用于全面的遗传分析和耐药性概况.

主要成果:

与非2系菌株 (P<0.05) 相比,2系M.tb菌株对利芬素 (RIF),异化 (INH) 和链杆菌素 (SM) 的耐药性显著更高 (P<0.05).
在检测耐药性方面,WGS表现出高灵敏度 (100%的RIF) 和特异性 (99.31%的INH),相当于pDST.
HRM表现出较低的敏感性,特别是对于INH耐药性 (52.94%),并且不足以取代pDST.

结论:

在M.tb血统中存在药物耐药性的显著差异,其中2系更具耐药性.
WGS是一种非常准确的方法来检测M.tb的耐药性,与pDST相比,可以识别新的耐药性突变.
目前,HRM的敏感性不足以在常规诊断中取代pDST,以检测M.tb的耐药性.

关键词:

结核病菌菌菌的结核病菌的结核病菌.药物耐药性耐药性药物耐药性血统谱系血统谱系血统谱系灵敏度灵敏度灵敏度灵敏度灵敏度特殊性的特异性进行全基因组测序.

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