【摘要】 目的研究我国结核分枝杆菌北京基因型菌株的分布以及与耐药表型的关系。方法2008年4～12月从我国6个区域收集痰涂片阳性的结核病患者的临床分离株,每一患者的一份分离株经生化方法鉴定为结核分枝杆菌复合群。收集患者的性别、年龄、病史、菌株耐药谱和菌株来源资料。药物敏感性实验采用比例法。运用间隔区寡核苷酸分型方法或基因dnaA～dnaN之间插入序列IS6110鉴定北京基因型菌株。结果在410份结核分枝杆菌分离株中,67.1%(275/410)的分离株属于北京基因型菌株,东北部区域感染北京基因型菌株患者的比例高于中西部区域(χ2=20.50,P=0.000)。患者的年龄、性别和治疗史与感染北京基因型菌株无关。在耐多药菌株和耐利福平菌株中,北京基因型菌株的比例显著高于非北京基因型(P=0.002,P=0.005)。结论患者的年龄、性别和治疗史与感染北京基因型菌株无关,东北部区域北京基因型菌株分布比例显著高于中西部区域。北京基因型菌株与利福平耐药和耐多药有关。更多还原

【Abstract】 Objective To investigate the distribution of the Beijing genotypes of Mycobacterium tuberculosis (M. tuberculosis) and the relationships between Beijing genotype strains and drug-resistant phenotypes in China. Methods Clinical isolates were collected during a 9-month research period from April to December in 2008 in six geographic regions of China. One isolate that had been biochemically confirmed to be a member of the M. tuberculosis complex was collected from each patient. The demographic data of the patients (eg. sex,age,and history of tuberculosis) as well as the drug resistance patterns and sources of the clinical isolates were collected. Drug susceptibility testing was performed using proportion method. Beijing genotypes of M. tuberculosis were identified by spacer oligonucleotide typing or insertion of IS6110 in the genomic dnaA-dnaN locus. Results Among the 410 M. tuberculosis clinical isolates,67.1% (275/410) isolates were Beijing genotypes of M. tuberculosis. Significantly larger proportions of tuberculosis patients were infected with Beijing genotypes in the northeastern regions of China than that of in the central-western regions (χ2=20.50,P=0.000). No significant associations were found either between Beijing genotype strains and patients’age,sex,or treatment history. Multidrug-resistant isolates and rifampin-resistant isolates were more common among Beijing genotype strains than among non-Beijing strains (P=0.002,P=0.005). Conclusions About two third of the clinical isolates of M. tuberculosis in China are Beijing genotypes. Beijing genotype strains are not correlated with patients’age,sex,treatment history. People living in the northeastern regions of China are more susceptible to Beijing genotypes than those living in the central-western of China.Beijing genotype strains tend to be rifampin-resistant or multidrug-resistant.更多还原