多细菌性麻风患者对抗麻风药物的耐药性:需要采取变革性行动
Rashmi Jindal1, Itu Singh2, Dikshita Goyal1
1Department of Dermatology, Venereology and Leprosy, Himalayan Institute of Medical Sciences, Dehradun, India.
对麻风药物的抗菌素耐药性 (AMR) 越来越令人担忧,有17%的患者表现出耐药性. 这项研究强调了需要进行常规AMR测试和局部监测,以对抗耐药性Mycobacterium leprae.
科学领域:
- 医学微生物学 医学微生物学
- 传染性疾病 传染性疾病
- 遗传学 是一个遗传学.
背景情况:
- 麻风病是由Mycobacterium leprae引起的,在全球范围内构成了重大公共卫生挑战.
- 抗微生物耐药性 (AMR) 对诸如利芬素,达普和奥洛素等多种药物治疗 (MDT) 的药物威胁到了麻风控制.
- 在rpoB,folP1和gyrA基因中的基因突变是AMR的关键机制.
研究的目的:
- 在多细菌性麻风患者中确定Mycobacterium leprae中初级和二级AMR率.
- 为了确定与药物耐药性相关的遗传突变,在第三级护理环境中.
- 评估对利芬素,达普和奥洛素耐药性的流行情况.
主要方法:
- 从2022年7月到2024年6月,从2022年7月到2024年6月的多细菌性麻风患者 (BI ≥2) 参与的前性,横截面研究.
- 聚合酶链反应 (PCR) 用于切割皮肤涂抹 (SSS) 来检测rpoB,folP1和gyrA基因的突变.
- 对抗性相关突变的放大样本进行DNA测序和分析,并收集人口和临床数据.
主要成果:
- 在47个样本中,43个样本得到了成功放大,揭示了17%的AMR (8/43例).
- 在没有接受过治疗的患者中,有20% (4/20) 观察到初级耐药性.
- 耐利芬素 (F439L突变) 是最常见的 (n=4),其次是达普 (P55L/S,n=2) 和对奥洛素的耐药性 (A91V/G89C,n=2).
结论:
- 对于高风险的麻风病例来说,例行AMR检测至关重要,以指导有效的治疗.
- 局部监测是必要的,以了解和管理抵抗模式的区域差异.
- 改进的诊断,患者教育和政策干预对于对抗麻风病的AMR至关重要.
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