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异化和花基诺隆耐药性的高频率在患有对利芬素敏感结核病的患者中
Parul Jain1, Rashmi Ratnam1, Senjuti Sengupta1
1Department of Microbiology, King George's Medical University, Lucknow, India.
Diagnostic microbiology and infectious disease
|December 15, 2023
概括
这项研究研究了Mycobacterium结核病菌的耐药性. 它发现了显著的异化和诺基诺耐药性,与katG和gyrA等特定基因突变驱动这种耐药性在利芬素敏感菌株.
科学领域:
- 微生物学 微生物学
- 遗传学 遗传学 是一个
- 公共卫生 公共卫生
背景情况:
- 结核病 (TB) 仍然是一个全球性卫生挑战,需要持续监测耐药性模式.
- 里芬辛耐药性是关键指标,但了解对其他一线和二线药物的耐药性对于有效治疗至关重要.
- 识别与耐药性相关的特定突变有助于诊断和治疗策略.
研究的目的:
- 为了确定异化 (INH) 和基诺 (FQ) 耐药性的频率,在对 rifampicin 敏感的 Mycobacterium 结核病菌株中.
- 分析与INH和FQ抵抗相关的突变模式.
- 为了解结核病中耐药性机制做出贡献.
主要方法:
- 通过基于盒子的核酸放大测试 (CBNAAT) 检测到的Mycobacterium结核病样本的回顾性分析.
- 基于耐药性模式的第一线 (FL) 和第二线 (SL) 线探测试 (LPA) 的序列测试.
- 对异化和诺基诺耐药性的突变概况的分析.
主要成果:
- 在13124个NAAT阳性样本中,9722个 (74.1%) 是对利芬素敏感的.
- 8.6%的对利芬素敏感菌株在FL-LPA.上表现出对异化 (INH) 的耐药性.
- 13.2%的INH耐药菌株也表现出对SL-LPA的诺 (FQ) 耐药性.
- 常见的INH抗性突变包括katG S315T1 (97.3%) 和 inhA C15T (86.6%).
- 主要的FQ抗性突变是gyrA D94G (41.8%).
- 观察到异质电阻和各种突变组合.
结论:
- 即使在对 rifampicin 敏感的 Mycobacterium 结核病菌株中,也存在显著的异化和诺基诺隆耐药率.
- 在katG,inhA和gyrA基因中的特定突变与INH和FQ耐药性密切相关.
- 了解这些突变模式对于准确的结核病诊断和指导治疗方案至关重要.
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