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通过基于表型和分子的测定来检测Mycobacterium结核病中的多药性耐药性

Laima Vasiliauskaitė^1,2,3, Zofia Bakuła^2,4, Edita Vasiliauskienė^1,2,3

¹Department of Physiology, Biochemistry, Microbiology and Laboratory Medicine, Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

Annals of clinical microbiology and antimicrobials

|August 28, 2024

概括

全基因组测序 (WGS) 显示出有望检测来自波兰和立陶宛的Mycobacterium结核复合体 (MTBC) 菌株的耐药性. 然而,像临界度 (CC) 测试这样的传统方法仍然与线式探针测试 (LPA) 结果更加一致.

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:

全基因组测序 (WGS) 是一种新兴的工具,用于检测Mycobacterium结核病综合体 (MTBC) 中的耐药性.
对于来自中欧和东欧国家的MTBC菌株,WGS性能存在有限的评估.
与传统药物敏感性测试 (DST) 相比,评估WGS对于了解其在不同地理区域的有用性至关重要.

研究的目的:

评估全基因组测序 (WGS) 在MTBC临床菌株中检测多药耐药 (MDR) 现型的性能.
将WGS结果与传统药物敏感性测试 (DST) 方法进行比较,包括临界度 (CC) 和最小抑制度 (MIC) 测试.
评估基于分子的技术,如线式探针测定 (LPA) 与WGS一起用于电阻检测.

主要方法:

来自波兰和立陶宛的208种MTBC菌株 (130种MDR,78种药物敏感) 的分析 (2018-2021年).
通过CC DST,MIC DST,LPA和WGS评估的对利芬素 (RIF) 和异化 (INH) 的耐药性.
使用生物信息管道和基于软件的工具分析WGS数据.

主要成果:

临界度 (CC) DST结果与线式探针测试 (LPA) 相比,与基于管道的WGS相比,显示出更好的一致性.
基于软件的WGS分析表明,对于RIF/INH电阻预测,与基于管道的WGS有很好的一致性.
最常见的RIF抗性突变是rpoB S450L;INH的MIC在双katG/inhA突变中更高.

结论:

针对一线抗结核药物的当前临界度 (CCs) 可能需要根据MIC DST结果进行修订.
这两种分子方法 (LPA和WGS) 均表现出100%的特异性.
与LPA相比,基于管道的WGS对RIF和INH的敏感性略低,当与CC DST进行评估时.

关键词:

药物敏感性测试是对药物敏感性的测试.在MDR-TB中,使用的是MDR-TB 最低抑制度的最小抑制度整个基因组测序的测序

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