2015年至2022年培养阳性结核病的耐药性特征
Zhenzhen Wang1,2, Liyang Xu2,3, Tengfei Guo1
1The First Affiliated Hospital, College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China.
Frontiers in public health
|June 9, 2025
概括
结核病药物耐药性率正在下降,其中 estreptomycin 和 isoniazid 的耐药性最高. 像rpsL,katG,rpoB和embB这样的基因中的关键突变驱动了耐药性,尽管不是唯一的.
科学领域:
- 传染病的分子流行病学.
- 抗微生物药物耐药性的机制
- 公共卫生和热带医学.
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.
- 了解耐药性的分子基础对于针对*Mycobacterium tuberculosis*复合体 (MTBC) 的有效治疗策略至关重要.
研究的目的:
- 确定MTBC分离物中对一线抗结核药物耐药性的流行率.
- 为了确定负责结核病患者耐药性的特定分子突变.
- 为开发针对性和区域特定的抗结核病治疗方案提供数据.
主要方法:
- 分析了2015-2022年间在中国洛阳市分离的3,605种MTBC菌株.
- 药物敏感性测试使用比例方法测试异化 (INH),利法 (RFP),菌素 (SM) 和乙醇 (EMB).
- 通过多色化曲线分析 (MMCA) 进行分子药物敏感性测试,以检测与耐药性相关的突变.
主要成果:
- 阻力率:SM (16.5%),INH (15.7%),RFP (9.9%),EMB (6.4%). 这三种类型的阻力比率都很高. 在城市地区观察到更高的比率.
- 在研究期间,单抗性 (MR-TB),多抗性 (MDR-TB) 和多抗性 (PDR-TB) 的下降趋势.
- 发现了关键突变: *rpsL*43 (SM), *katG*315 (INH), *rpoB*529-533 (RFP), *embB*306 (EMB). 这些突变包括: 多抗药性结核病和PRD结核病往往涉及这些热点突变的组合.
结论:
- 结核病耐药率有所下降,耐药性概况的区域差异显著.
- 特定基因的常见热点突变是药物耐药性的主要驱动因素,但其他突变也会有所贡献.
- 这些发现支持了对结核病持续监测和量身定制的治疗方法的需求.
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