Table of Content

10 January 2006, Volume 28 Issue 1

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Identification of drug-resistant gene type in Mycobacterium tuberculosis by PCR-oligonucleotide microchips

Wu Xueqiong¹,Zhang Qiong,Zhang Junxian,et al

. 2006, 28(1):  4-10. 

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Objective To identify drug-resistant gene type in Mycobacterium tuberculosis isolates by PCR-oligonucleotide microchips,and to develop a new,rapid method for drug resistance.Method Using traditional drug susceptibility testing and PCR-DNA sequencing as control,katG,rpoB,rpsL,rrs,and embB genes from 157 M tuberculosis clinical isolates were analyzed by PCR-oligonucleotide microchip.Results The(katG,rpoB),rpsL,rrs,and embB genes from 36 drugsensitive M tuberculosis isolates analyzed were all wild-types.Of 121 drugresistant M tuberculosis isolates,56 isolates were resistant to INH,in which 62.5% had alterations in the katG,codon 315 is the most common site of gene mutation;94.2%(98/104) rifampicin-resistant isolates had rpoB gene mutations.Codon 531 and 526 of the rpoB are the most common sites of nucleotide substitutions, the mutations at codon 511,513,515,516,517,518 and 533 were also found.88.7% of 62 streptomycin-resistant isolates had mutations of the rpsL(82.3%) and rrs(6.5%) genes.There were mutations at codon 43,88 of the rpsL and position 513,516 of rrs.61.4% of 57 ethambutol-resistant isolates had nucleotide substitutions(ATG→GTG or ATA,ATC,ATT,CTG) at codon 306.The mutations found by gene chip were consistent with the Results of DNA sequencing.Conclusion The drug-resistant genetypes in the most drug-resistant Mycobacterium tuberculosis isolates could be identified with PCR-oligonucleotide microchip.

Detection of rpoB gene mutation of Mycobacterium tuberculosis in sputum specimens by nested PCR-DNA sequencing

Xiong Guoliang,Zhang Huihui,Liu Zhenqiong.

. 2006, 28(1):  11-13. 

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Objective To detect rpoB gene mutation of rifampin-resistant Mycobacterium tuberculosis insputum specimens by nested PCR-DNA sequencing,and to evaluate its value in clinical applications to develop arapid method for the detection of rifampin-resistance in Mycobacterium tuberculosis.Method One handred and twelve sputumspecimens from the patients with active pulmonary tuberculosis and 20 sputum specimens from the patients withnon-tuberculous pulmonary disease were detected by nested PCR-DNA sequencing,smear,culture,and speciesidentification.Results Thirty-one of 112 sputum specimens from the patients with active pulmonarytuberculosis had mutations of rpoB gene in M.tuberculosis by nested PCR-DNA sequencing.Of 32 sputumspecimens with rifampin-resistant strains,29 had rpoB mutations,and the mutation rate was 90.6%(29/32).2 of 39 sputum specimens with smear and culture negative had rpoB mutations.No mutation was found in 37 sputumspecimens with rifampin-sensitive strains(specificity 100%). Conclusion Nested PCR-DNA sequencing maybecome an accuracy,specific,rapid method for direct detection of rpoB gene mutation in Mycobacteriumtuberculosis from clinical specimens.

Clinical evaluation on the detection of Mycobacterium tuberculosis by four methods

Zhang Yi,Lu Jianping,Ye Miao.

. 2006, 28(1):  14-17. 

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Objective To evaluate the clinical application value of sputum smear,culture,polymerasechain reaction(PCR) and bacterium proliferation PCR(BP-PCR) for the detection of Mycobacterium tuberculosis.Method One hundred and twenty-four sputum specimens frompatients with pulmonary tuberculosis,suspicious pulmonary tuberculosis,and non-tuberculosiswere detected for Mycobacterium tuberculosis by four methods,and the Results from four methodswere compared.Results The positive rates for the detection of Mycobacterium tuberculosis were 22.5%,32.2%,54.8%,64.5% and 87.1% in 31 sputums from the patients with pulmonary tuberculosis by smear,culture,PCR,and BP-PCR in 4 or7 days,respectively.The positive rateswere 13.6%,18.6%,28.8%,37.3% and 52.5% in 59 samples from the patients with suspicious pulmonary tuberculosis,respectively.There was a significant difference(P<0.05) among four methods. Of 34 sputum samples from the non-tuberculous patients,all were negative by smear and culture methods,but one was positive(2.9%) by PCR and BP-PCR methods,respectively.The positive rate of BP-PCR for detection of Mycobacterium tuberculosis was significantly higher than that of the PCR,but the false positive rate had no difference.Conclusion The BP-PCR assay hadhigh sensitivity and specificity,and might be used for the diagnosis of pulmonary tuberculosis.

Effect of implementing DOTS strategy in Dongguan during 1992—2001

Guo Huangchao,Zhou Zhigang,Wu Heyang,et al.

. 2006, 28(1):  18-20. 

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Objective To analyze the effect of implementing DOTS strategy in Dongguang.Method The data from TB quarterly,annual reporting system and other related information during 1992—2004 was collected and analyzed.Results During 10 years,the total TB control funds was 3163700 Yuan(RMB).27299 TB suspects had been examined and 4330 cases with pulmonary tuberculosis had been treated free of charge.The average cost for per case is 730.65 Yuan(RMB).The trend in the notification rate,negative conversion rate and cure rate showed up by years.The treatment course was shorten to 24 monthsand the average cure rate of initial cases and re-treatment cases with smear-positive were 98%and 84.4% respectively.Conclusion The successful implementation of DOTS strategy made thenotion of anti-tuberculosis to be changed.It lead the TB control into a new stage of standardized management.

Investigation for the infection of transfusion transmitted virus and hepatitis G virus in the patients with tuberculosis in Baise city

Huang Qiwen,Huang Zhongmin,Qin Yaqin,et al.

. 2006, 28(1):  21-24. 

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Objective To determine the infection status and clinical significance of transfusion transmitted virus(TTV) and hepatitis G virus(HGV) in the patients with tuberculosis in Baise minority nationality regions.Method Anti-TTV and anti-HGV were detected with enzyme linked immune absorption assay(ELISA) in the serums of 712 tuberculosis patients and 500 control subjects.TTV-DNA was detected with polymerase chain reaction(PCR) in the subjects which anti-TTV was positive.HGV-RNA was detected with PT-nPCR in the subjects which anti-HGV was positive.Clinical character of tuberculosis patients with positive TTV DNA or positive HGV-RNA was investigated.Results The infection rate of TTV was 16.71% in the tuberculosis patients and 5.60% in the control subjects.The infection rate of HGV was 14.61% in the tuberculosis patients and 2.60% the in control subjects.There is significant difference in two groups(P<0.01).The infection rate of TTV and HGV has a trend to rise by age in the tuberculosis patients.The rate in male group is higher than in female group(P<0.05).And the infected people have a higher rate of having blood transfusion and injection history than the uninfected people.Liver injury resulting from antitubercular drugs is more common occurred in the patients infected with TTV-DNA and HGV-RNA during tuberculosis therapy(P<0.01).Conclusion The Results of the study suggest that the infection rate of TTV and HGV is in a relatively high level in the tuberculosis patients.Immune function damage and multi-injection may contribute to it.And the infected patients are easier to suffer the liver damage during tuberculosis therapy.

Analysis on tuberculosis control status of floating population in Haizhu of Guangzhou.

Zhong Jing,Mai Jieer,Luo Yilu,et al.

. 2006, 28(1):  25-27. 

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Objective To analyze the epidemiological feature of pulmonary tuberculosis in floating population in Haizhu of Guangzhou and find out the scientific basis of tuberculosis control in floating population.Method New registered pulmonary tuberculosis cases in floating population in 2002—2003 were investigated and the forms of Socio-Economic Status of tuberculosis in floating population were filled and the cases were followed up for one year.The data were analysed with SPSS10.0.Results There were 225 cases with tuberculosis receiveing treatment and investigation,41.7% of the cases were smear positive and the cure rate was 95.7%.There were the most cases in 25～34 age-group, occupied 47.1%.The percentage of physical labourer was 48.9%.83.1% of cases were detected through clinical consultation means.The percentage of cases that annual income less than(10000) yuan was 75.1.4%.Conclusion The majority of cases in floating population were in lower income and the low income was the risk factor of tuberculosis infection.

The analysis of causes that result in re-treatment of drug-resistant tuberculosis in Zhejiang

Xu Xuqing,Chen Kun,Li Qun.

. 2006, 28(1):  28-30. 

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Objective To study the different causes that result in re-treatment of drug-resistant and drug-sensitive TB in Zhejiang in order to find the risk factors that result in acquired drug-resistant TB.Method 15 counties were randomly selected from 30 surveillance counties of a global drug-resistance surveillance of TB project of WHO.Drugresistance and drug-sensitive TB cases were intaken continuously in each counties.The method of epidemiological survey with questionnaire was used.Results Between drug-resistance and drug-sensitive TB,there was no significant difference in the proportion of initial treatment unit and management mode.But there was difference in the proportion of re-treatment cluration and re-treatment causes.The main reasons of re-treatment were that the patients who treated in general hospital,or did not manage by health workers or irregularly treated.Conclusion The risk factors that result in acquired drug-resistant TB were long-term re-treatment and irregularly treated.

Analysis on imaging features Of pulmonary tuberculosis in immune hypofunction patients

Li Youcai,Shen Mingyan.

. 2006, 28(1):  31-33. 

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Objective To evaluate X-ray and CT features Of pulmonary tuberculosis in diabetic patients,patients with dropsical nephritis,patients with systemic lupus erythematosus(SLE),and patients with acquired immunodeficiency syndrome(AIDS).Method Retrospective analysis were done on CT scans and X-ray features Of pulmonary tuberculosis cases combined with 68 with diabetiC(68),with dropsical nephritis(20),with SLE(12),with AIDS(8).Results X-ray and CT features of pulmonary tuberculosis combined With diabetic included larger infiltrate consolidation(45 cases),multiple cavities with infiltrate consolidation(40 cases),nosegmental distribution(23 cases),bronchi disseminate focus(21 caseS),and pleural fluid(10 cases).The X-ray and CT appearances of pulmonary tuberculosis patients combined with dropsical nephritis or SLE inclUded acute hematogenous dissemination pulmonary tuberculosis(15 cases),vary sized infiltrate consolidation(17 cases),complicating lymphadenectasis in hilum of lung and mediastinum(4 cases).The CT findings of pulmonary tuberculosis combined with AIDS were patch shadow complicated With lymphadenectasis(5 cases),and acute hematogenous dissemination pulmonaryary tuberculosis complicated with lymphadenectasis(3 cases) Conclusion The main radiological findings of pulmonary tuberculosis in immune hypofunction patients appear larger infiltrate consolidation,multiple cavities within infiltrate consolidation,bronchi disseminate,acute hematogenous dissemination pulmonary tuberculosis,lymphadenectasis in hilum of lung and mediastinum,and infiltrate tuberculosis consolidation in uncommon parts.

Analysis on 11 non-tuberculous mycobacterium infection of hand in littoral area

Chen Qingshan,Zhang Weiwen,Chen Hong,et al

. 2006, 28(1):  34-36. 

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Objective To explore the in-vivo culturing technique of mycobacteria from special hand infections in laboratory,and to provide the direct evidence for clinical diagnosis.Method To review Acid-Fast Stain,mycobacterial culture,identification by chemistry and gene sequesing of 28 cases of hand special chronic infections.Results Only 2 cases were positive in Acid-Fast Stain,10 cases showed positive by mycobacterial culture,and 8 M.marinum,1 M.fortuitum,1 M.avium.Conclusion Mycabacterium were the major factor of hand special chronic infections,and of all non-tuberculous mycobacterium(NTM),M.marinum was the most important one which should be paid more attention when culturing.It is necessarily to culture them at both 35℃ and 30℃.

Fiberoptic bronchoscopic balloon dilatation for tubercular bronchial stenosis

Wu Zhilong,Zhang Xilin,Liao Weiping,et al.

. 2006, 28(1):  37-39. 

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Objective To evaluate the efficacy and safety of fiberoptic bronchoscopic balloon dilatation for tubercular bronehial stenosis.Method Thirteen patients with tubercular bronehial stenosis were treated by balloon dilatation through flexible fiberoptic bronchoscopy.The patients with active tuberculosis were treated with chemotherapy and local administration through bronchofiberoscope.Results 10 of 13 patients achieved satisfactory dilatation.The average airway diameter in the stenotic segment increased from(2.7±1.3)mm to(5.8±1.7)mm(P<0.01).Three patients were failed.Ten sucessfus case were followed for 6～18 monthes.The stenotic segments in the 10 patients were kept permanent improvement.6 of 10 patients were positive sputum bacillus before the dilatation,the six patients were negative sputum bacillus.8 of 13 cases complained mild pain in the chest.There were no severe complications were found in these patients.Conclusion Fiberoptic bronchoscopic balloon dilatation is a simple but safe and effective treatment approach for tubercular bronehial stenosis.It is one of the effective ways for those patients who were frequently positive sputum bacillus as bronehial stenosis inducing obstruction.