结核性脑膜炎临床分离株的耐药性和基因型相关性分析

doi:10.3969/j.issn.1000-6621.2014.06.002

中国防痨杂志 ›› 2014, Vol. 36 ›› Issue (6): 411-417.doi: 10.3969/j.issn.1000-6621.2014.06.002

结核性脑膜炎临床分离株的耐药性和基因型相关性分析

王婷赵雁林逄宇周杨冯国栋彭晋湘赵钢

710032 西安，第四军医大学西京医院神经内科（王婷、冯国栋、赵钢）；中国疾病预防控制中心结核病预防控制中心国家参比实验室（赵雁林、逄宇、周杨）；解放军第四七八医院空勤科（彭晋湘）

收稿日期:2013-07-16 出版日期:2014-06-10 发布日期:2014-06-28
通信作者: 赵钢；赵雁林 E-mail:zhaogang@fmmu.edu.cn; zhaoyanlin@chinatb.org
基金资助:
“十一五”国家科技重大专项(2012ZX10003004)

Analysis of the relativity between the drug resistance and genotype of clinical strains isolated from tuberculous meningitis

WANG Ting, ZHAO Yan-lin, PANG Yu, ZHOU Yang, FENG Guo-dong, PENG Jin-xiang, ZHAO Gang

Department of Neurology, Xijing Hospital, the Fourth Military Medical University, Xi’an, Shaanxi 710032, China

Received:2013-07-16 Online:2014-06-10 Published:2014-06-28
Contact: ZHAO Gang；ZHAO Yan-lin E-mail:zhaogang@fmmu.edu.cn; zhaoyanlin@chinatb.org

摘要/Abstract

摘要： 目的了解结核性脑膜炎（tuberculous meningitis，TBM）的致病菌在耐药性和基因型方面的相关性。方法从500例疑似TBM患者脑脊液标本中经MGIT（Mycobacteria growth indicator tube）960培养仪分离培养出25株结核分枝杆菌（Mycobacterium tuberculosis，Mtb），对这25株Mtb分别进行间隔区寡核苷酸分型（Spoligotyping）法基因分型、14种抗结核药物的药物敏感性试验、10个耐药基因测序。结果 20株为北京基因型，占80.0%（20/25）；耐多药结核性脑膜炎（MDR-TBM）有3株（3/25），都属于北京基因型；测序结果显示inhA、embB、gyrB、eis基因未发生突变，katG、rpoB、gyrA、rrs-KAN、rpsL、gidB基因发生突变。结论北京基因型在耐药TBM中所占比例高，尤其是MDR-TBM。耐药TBM临床分离株与相关耐药基因突变有关系。

关键词: 结核, 脑膜, 抗药性, 细菌, 分枝杆菌, 结核, 基因型

Abstract: Objective To study the relativity between the drug resistance and genotype of clinical strains isolated from tuberculous meningitis(TBM). Methods M. tuberculosis was cultured and isolated in cerebrospinal fluids (CSF) from 25 cases diagnosed with TBM in Xijing Hospital. These isolates were performed the susceptibility testing of 14 antituberculosis drugs, the sequencing of 10 drug-resistant genes and strain typing by Spoligotyping. Results Of 25 M. tuberculosis isolates, 20 (80.0%) clinical isolates were identified as Beijing genotype by Spoligotyping; 3 (3/25) strains were multidrug-resistant (MDR) and belonged to Beijing genotype, in which katG, rpoB, gyrA, rrs-KAN, rpsL, gidB genes were found the mutations, but inhA, embB, gyrB, eis genes had not mutation by the DNA sequencing. Conclusion Beijing genotype strains may act as the main epidemic strain of TBM，especially MDR-TBM.

Key words: Tuberculosis, meningeal, Mycobacterium tuberculosis, Drug resistance, bacterial, Genotype

王婷，赵雁林，逄宇，周杨，冯国栋，彭晋湘，赵钢. 结核性脑膜炎临床分离株的耐药性和基因型相关性分析[J]. 中国防痨杂志, 2014, 36(6): 411-417. doi: 10.3969/j.issn.1000-6621.2014.06.002

WANG Ting, ZHAO Yan-lin, PANG Yu, ZHOU Yang, FENG Guo-dong, PENG Jin-xiang, ZHAO Gang. Analysis of the relativity between the drug resistance and genotype of clinical strains isolated from tuberculous meningitis[J]. Chinese Journal of Antituberculosis, 2014, 36(6): 411-417. doi: 10.3969/j.issn.1000-6621.2014.06.002

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结核性脑膜炎临床分离株的耐药性和基因型相关性分析

Analysis of the relativity between the drug resistance and genotype of clinical strains isolated from tuberculous meningitis

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