结核菌菌的抗微生物耐药性特征与治疗失败有关
Fizza Mushtaq1,2, Syed Mohsin Raza1, Adeel Ahmad3
1Institute of Biomedical and Allied Health Sciences, University of Health Sciences, Lahore, Pakistan.
PloS one
|October 26, 2023
概括
结核病的治疗失败通常与多药耐药 (MDR) 结核菌菌株有关. 这项研究发现了MDR结核病的高发病率和对二线药物如阿米卡的耐药性,这表明治疗挑战.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 结核病 (TB) 治疗需要六个月的多种药物,这对完成和有效性提出了挑战.
- 结核病治疗失败是一个重大的公共卫生问题,特别是在发展中国家.
- 了解Mycobacterium结核病的耐药性模式对于有效的结核病管理至关重要.
研究的目的:
- 为了研究Mycobacterium结核病菌的抗微生物药物耐药性特征,从经历治疗失败的患者中分离出来.
- 评估二线药物 (阿米卡辛,线索利德,莫西素) 和维拉帕米尔对抗耐药的M.结核病菌株的疗效.
- 在治疗失败的情况下识别与药物耐药性相关的遗传突变.
主要方法:
- 在拉合尔监测1200名结核病患者,在标准治疗后发现64例治疗失败.
- 从患者唾液中分离的M.结核病菌的抗菌感应性测试.
- 对关键抗性相关基因 (katG,pncA) 的突变进行基因定型,并分析排泄基因表达.
主要成果:
- 在治疗失败的孤立群体中,多抗药性 (MDR) M.结核病 (71.9%) 和耐胺 (46.9%) 的高患病率.
- 对阿米卡辛的显著耐药性 (26.5%),对线化物 (3.1%) 和莫西素 (1.5%) 的比率较低.
- 鉴定了与耐药性相关的常见katG Ser315突变和新型pncA突变;维拉帕米尔对耐药菌株的影响有限.
结论:
- 高水平的MDR结核病和对二线药物如阿米卡的耐药性使治疗结果复杂化.
- 在katG和pncA中的特定基因突变与观察到的抗药性模式密切相关.
- 目前的二线药物治疗方案可能需要重新评估,特别是阿米卡辛,因为观察到的耐药性.
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