| 张治国,吴进凤,王莉,王路钦,韩露,马树波,高铁杰.北京市昌平地区2011-2015年结核分枝杆菌的流行特征[J].中华流行病学杂志,2017,38(9):1236-1240 |
| 北京市昌平地区2011-2015年结核分枝杆菌的流行特征 |
| Genotyping and drug susceptibility of Mycobacterium tuberculosis isolated in Changping district in Beijing, 2011-2015 |
| 收稿日期:2017-04-01 出版日期:2017-09-09 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.09.019 |
| 中文关键词: 结核病 流行 耐药 北京 |
| 英文关键词: Tuberculosis Prevalence Drug resistance Beijing |
| 基金项目:北京市自然科学基金（7174323）；北京市教育委员会科技发展计划重点项目（KZ201510025024） |
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| 中文摘要: |
| 目的 了解昌平地区结核分枝杆菌不同基因型流行特征，以及不同基因型和耐药性的关系，探讨基因分型用于评价本地区结核病控制中的应用价值。方法 选取北京市昌平区2011-2015年所有培养阳性结核分枝杆菌1 099株，采用Spoligotyping和Gao等推荐的12位点VNTR进行基因分型，同时检测上述菌株对利福平、异烟肼、乙胺丁醇、链霉素、阿米卡星和氧氟沙星的耐药性。结果 2011-2015年，昌平地区结核对氧氟沙星耐药率提高（2.9%比8.9%，P=0.01）。在所有菌株中，北京基因型菌株总计976株，占88.8%，非北京基因型菌株总计123株，占11.2%，其中北京基因型菌株中还包括189株（17.2%）古代北京基因型和787株（71.6%）现代北京基因型。北京基因型所占比例在5年期间无显著性变化，从2011年的81.1%到2015年的82.0%。采用VNTR基因分型后，仅有2株菌成簇，成簇率为0.1%。北京基因型对阿米卡星的耐药率（1.7%）低于非北京基因型（4.9%，P=0.02）；而古代北京基因型对链霉素耐药率（28.0%）高于现代北京基因型（15.7%，P=0.01）。结论 近5年来，昌平地区结核对氧氟沙星耐药率提高。北京基因型所占比例在5年期间无明显变化，且菌株成簇率较低，提示近期传播率低。 |
| 英文摘要: |
| Objective To understand the genotype distribution of Mycobacterium tuberculosis and the drug susceptibility of M. tuberculosis with different genotypes in Changping district of Beijing and evaluate the application of genotyping of M. tuberculosis in local tuberculosis (TB) prevention and control. Methods A total of 1 099 M. tuberculosis strains isolated in Changping from 2011 to 2015 were used. Spoligotyping and 12-locus VNTR recommended by Gao were used for the genotyping of these isolates. In addition, the susceptibility of the M. tuberculosis isolates to rifampin (RFP), isoniazid (INH), ethambutol (EMB), streptomycin (SM), amikacin (AMK) and ofloxcin (OFX) were detected by using conventional drug susceptibility test. Results From 2011 to 2015, the detection rate of OFX-resistance increased from 2.9% to 8.9% (P=0.01). Of all the M. tuberculosis isolates, 976 belonged to Beijing genotype (88.8%), and the other 123 belonged to non-Beijing genotype (11.2%). In addition, there were 189 ancient Beijing genotype isolates and 787 modern Beijing genotype isolates, respectively. The proportion of Beijing genotype strains showed no significant increase in the past five years (81.1% in 2011 vs. 82.0% in 2015). On the basis of VTNR genotyping, only 2 isolates belonged to one cluster (0.1%). In addition, the AMK resistant rate of Beijing genotype strains (1.7%) was significantly lower than that of non-Beijing genotype strains (4.9%, P=0.02). Compared with modern Beijing genotype strains, the SM resistant rate of ancient Beijing genotype strains was significantly higher (28.0% vs. 15.7%, P=0.01). Conclusions In the past five years, the OFX-resistant rate of M. tuberculosis in Changping was in increase. There was no significant difference in the detection of Beijing genotype strains during this period. In addition, the low clustering rate indicated that the TB transmission rate was low in Changping. |
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