本文選題：結(jié)核分枝桿菌 + 耐多藥��； 參考：《第三軍醫(yī)大學(xué)學(xué)報(bào)》2017年12期

【摘要】：目的對(duì)重慶地區(qū)耐多藥結(jié)核患者結(jié)核分枝桿菌進(jìn)行基因分型,明確該地區(qū)基因類(lèi)型的特征和流行情況。方法連續(xù)收集重慶市公共衛(wèi)生醫(yī)療救治中心和重慶市第十二人民醫(yī)院結(jié)核內(nèi)科2013年7月至2015年3月753例臨床診斷為耐多藥結(jié)核患者的痰液或其他體液,采用液體培養(yǎng)法分離培養(yǎng)分枝桿菌,采用PCR方法對(duì)分枝桿菌分離株進(jìn)行菌種鑒定,并使用多位點(diǎn)數(shù)目可變串聯(lián)重復(fù)序列分析(multiple locus variable number of tandem repeat analysis,MLVA)方法進(jìn)行基因分型。采用Bionumerics Version 3.0和phyloviz軟件進(jìn)行各基因位點(diǎn)的多態(tài)性和成簇分析。結(jié)果共分離培養(yǎng)出538例耐多藥分枝桿菌菌株,經(jīng)PCR鑒定確認(rèn)結(jié)核分枝桿菌有503例(95.8%),非結(jié)核分枝桿菌有35例(4.2%)。北京家族型470例(93.4%,470/503),非北京家族型33例(6.6%,33/503)。503例分枝桿菌菌株共分為348個(gè)基因型,其中267例患者分離株為單一基因型,其余236例菌株可歸入81個(gè)簇,成簇率為30.8%。北京家族型有76個(gè)簇,成簇率為30.8%,成簇比例為35.9%,非北京家族型有5個(gè)簇,成簇率為30.3%,成簇比例為33.3%。不同特征的耐多藥結(jié)核人群對(duì)結(jié)核分枝桿菌北京基因型菌株易感因素分析:感染北京基因型菌株與性別無(wú)顯著性關(guān)聯(lián)(χ~2=2.68,P0.05);與年齡呈顯著性關(guān)聯(lián)(χ~2=784.00,P0.05)。結(jié)論重慶地區(qū)耐多藥結(jié)核分枝桿菌的基因型存在明顯的多態(tài)性,北京基因型占絕對(duì)優(yōu)勢(shì);不同特征耐多藥結(jié)核人群感染北京基因型菌株與性別無(wú)關(guān),與年齡相關(guān)。
[Abstract]:Objective to study the genotyping of Mycobacterium tuberculosis in multidrug resistant tuberculosis (MDR-TB) patients in Chongqing. Methods from July 2013 to March 2015, 753 cases of sputum or other body fluids were collected from Chongqing Public Health Medical treatment Center and Department of Tuberculosis, 12th people's Hospital of Chongqing, which were clinically diagnosed as MDR-TB. Mycobacterium was isolated and cultured by liquid culture method, identified by PCR method, and genotyped by multilocus variable tandem repeat sequence analysis and multiple locus variable number of tandem repeat analysis (MLVA) method. Bionumerics Version 3.0 and phyloviz software were used to analyze the polymorphism and clustering of gene loci. Results A total of 538 strains of Mycobacterium multidrug resistance were isolated and cultured. By PCR identification, 503 cases of Mycobacterium tuberculosis and 35 cases of non-Mycobacterium tuberculosis were identified as Mycobacterium tuberculosis. 470 strains of Beijing family type were divided into 348 genotypes, 267 of them were single genotypes, and the remaining 236 strains could be classified into 81 clusters, with a clustering rate of 30.8. There are 76 clusters in Beijing family type with a clustering rate of 30.8 and a cluster ratio of 35.9.The non-Beijing family type has 5 clusters with a clustering rate of 30.3 and a cluster ratio of 33.3. Analysis of susceptibility to Mycobacterium tuberculosis strains of Beijing genotype in the population with different characteristics of MDR-TB: there was no significant correlation between Beijing genotype strains and sex (蠂 ~ (2 +) 2.68) (P0.05), but there was a significant correlation with age (蠂 ~ (2) 784.00 (P0.05). Conclusion the genotype of multidrug resistant Mycobacterium tuberculosis in Chongqing area is obviously polymorphic, and Beijing genotype is the dominant genotype, and the infection of Beijing genotype in different characteristics of MDR-TB population is not related to sex, but is related to age.
【作者單位】： 重慶市公共衛(wèi)生醫(yī)療救治中心檢驗(yàn)科;重慶市第十二人民醫(yī)院檢驗(yàn)科;重慶市公共衛(wèi)生醫(yī)療救治中心耐多藥結(jié)核病管理辦公室;重慶市公共衛(wèi)生醫(yī)療救治中心結(jié)核重點(diǎn)實(shí)驗(yàn)室;重慶市公共衛(wèi)生醫(yī)療救治中心病案室;重慶醫(yī)科大學(xué)附屬第三醫(yī)院骨與創(chuàng)傷中心;
【基金】：重慶市衛(wèi)生局2012年醫(yī)學(xué)科研重點(diǎn)項(xiàng)目(2012-1-085)~~
【分類(lèi)號(hào)】：R440;R52

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