【摘要】 目的 分析广州地区利奈唑胺（linezolid,LZD）耐药结核分枝杆菌临床分离株耐药基因的突变特征，为控制广州地区耐利奈唑胺结核病提供一定的研究基础和依据。方法 选取2012年1月～2022年1月广州市胸科医院住院患者的60株利奈唑胺耐药结核分枝杆菌的临床分离株，分为耐多药组和广泛耐药组。采用微孔板稀释法对60株菌株进行利奈唑胺最低抑菌浓度（MIC）检测，并对60株菌株的利奈唑胺耐药基因23S rRNA、rplC、rplD进行测序，分析其突变特征。结果 60株LZD耐药株对LZD的MIC值分布于2～32μg/ml之间。耐多药组的MIC₅₀和MIC₉₀分别为2μg/ml、32μg/ml，广泛耐药组的MIC₅₀和MIC₉₀分别为8μg/ml、32μg/ml。60株菌株中发现有12株23S rRNA基因发生突变，其中有1株发生两个基因位点突变；有11株rplC基因发生突变，其中有1株发生双位点突变；发现2株rplD基因发生突变。23S rRNA、rplC基因突变发生率在不同性别和年龄患者中差异无统计学意义（P>0.05）。结论 广州地区利奈唑胺耐药结核分枝杆菌耐药基因23S rRNA、rplC突变发生率明显高于rplD，在不同性别和不同年龄患者中的发生率无显著差异。更多还原

【Abstract】 Objective To analyze the mutation characteristics of linezolid（LZD） resistance gene in drug-resistant mycobacterium tuberculosis isolates in Guangzhou,and to provide a foundation for controlling linezolidin-resistant tuberculosis.Methods Sixty strains of LZD-resistant mycobacterium tuberculosis isolated from hospitalized patients in Guangzhou Chest Hospital from January 2012 to January 2022 and divided into multi-drug resistance group and pan-drug resistance group.The MICs of linezolidin of the 60 strains were determined by microplate dilution method.The genes,related to LZD resistance,of 23S rRNA,rplC and rplD of 60 strains were sequenced and their mutation characteristics were analyzed.Results The MIC values of the 60 strains against LZD ranged from 2μg/ml to 32μg/ml.The MIC₅₀ and MIC₉₀ in multi-drug resistance group were 2μg/ml and 32μg/ml,respectively,while those in pan-drug resistance group were 8μg/ml and 32μg/ml,respectively.Among the 60 strains,12 strains had mutations in the 23S rRNA gene,and 1 strain had two mutations.There were 11 strains of rplC gene mutation,of which 1 strain had double-site mutation.Two isolates had mutations in rplD gene.There were no significant difference in mutation rates of 23S rRNA and rplC gene among different genders and ages（P>0.05）.Conclusion The mutation rates of 23S rRNA and rplC genes in drug-resistant mycobacterium tuberculosis are significantly higher than rplD gene in Guangzhou,but there is no significant difference in mutation rate among different genders and ages.更多还原