摘要
目的探讨结核分枝杆菌北京基因型菌株的流行特征及其与耐药的关系。方法2007年我国开展全国结核病耐药基线调查，调查覆盖除香港、澳门和台湾地区外的全国31省（自治区、直辖市），含70个调查点。本研究对来自基线调查的3861例涂阳结核病患者的分离菌株进行分析，采用比例法进行药物敏感性试验，以间隔区寡核苷酸分型（Spoligotyping）方法对结核病患者的分离株进行基因分型。采用EpiInfo3．5．1建立数据库，SAS9．1软件进行统计学分析，以卡方检验分析不同变量之间的关系，以P〈0．05为有统计学意义。结果北京基因型菌株在我国广泛流行，占总分离菌株的63．97％（2470／3861）。感染北京基因型菌株与年龄（〈30岁和≥60岁：OR=0．9604，95％CI=0．7995～1．1536；30～岁和≥60岁：OR=1．0620，95％CI=0．9071～1．2434，x^2=0．3885，Ptrend=0．6977）、性别（OR=1．1526，95％CI=0．9973～1．3321，x^2=3．7024，P=0．0543）无关；北京基因型菌株与抗结核药物INH（OR=0．9020，95％CI=0．766～1．0619，x^2=1．5356，P=0．2153）、RFP（OR=1．0017，95％CI=0．8166～1．2288，x^2=0．0003，P=0．9868）、Sm（OR=0．9406，95％CI=0．8139～1．08711，x^2=0．6869，P=0．4072）、EMB（OR=0．9222，95％Ci=0．7205～1．1804，X^2=0．4140，P=0．5199）、Ofx（OR=0．9624，95％CI=0．6923~1．3378，x^2=0．0520，P=0．8196）和Km（OR=1．1666，95％CI=0．7624～1．7852，x^2=0．5049，P-0．4774）任何耐药均无关联；与单耐INH（OR=0．9955，95％CI=0．7206~1．3753，x^2=0．0007，P=0．9783）、RFP（OR=0．9615，95％CI=0．4880～1．8944，x^2=0．0129，P=0．9096）、EMB（O=0．5533，95％CI=0．2023～1．5136，x^2=1．3675，P=0．2422）、0fx（OR=0．8445，95％CI=0．3965～1．7984，x^2=0．1926，P=0．6608）、Km（OR=1．7779，95％CI=0．4440~7．1203，x^2=0．6791，P=0．4099）也均无关联；与耐多药（MDR）（OR=0．9884，95％CI=0．7594~1．2284，x^2=0．0110，P=0．9166）和广泛耐药（XDR）（OR=1．1502，95％CI=0．5372~2．4626，x^2=0.1300，P=0．7185）均无显著性关联。结论我国是北京基因型菌株的高流行区，感染北京基因型菌株与年龄、性别无关，北京基因型菌株与耐药无关。
Objective To explore epidemic characteristics of Mycobacterium tuberculosis of Beijing genotype and associations of Beijing genotype strains with drug resistance. Methods National tuberculosis （TB） drug re- sistance baseline survey was conducted in 2007, 70 clusters were randomly selected from 31 provinces （Autonomous region, Municipalities）, excepting Hongkong, Macao and Taiwan regions. 3861 Mycobacterium tuberculosis strains isolated from smear positive TB patients participating in the survey were analyzed in this study. Drug susceptibility test was determined by the proportion method, Mycobacterium tuberculosis strains were genotyped by spacer oligonu-cleotide typing （spoligotyping）. Database was set up by use of Epi Info software, version 3.5.1 （CDC）, and the da- ta was analyzed by SAS software, version 9.1, Chi square test was used to explore associations between different variables and the level of significance was set to P〈0. 05. Results Beijing strains of Mycobacterium tuberculosis were widespread in China, the total prevalence was 63.97% （2470/3861）. There were no statistical significant as sociations between Beijing genotype strains infected with age （% 30 vs ≥ 60：OR = 0. 9604, 95% CI = 0. 7995- 1. 1536;30-- vs ≥60：OR=1. 0620,95%CI=0. 9071--1. 2434, x^2 =0. 3885,Ptrend =0. 6977）, sex （OR= 1. 1526, 95 % CI = 0.9973-- 1.3321, x^2 = 3. 7024, P= 0. 0543）, respectively; there were no statistical significant associations between Beijing genotype strains and any resistant to INH （OR= 0. 9020,95 %CI= 0. 766--1. 0619, x^2 = 1. 5356, P=0. 2153）, RFP （OR=1. 0017,95%CI=0. 8166--1. 2288, x^2 =0. 0003,P=0. 9868）, Sm （OR=0. 9406,95%CI= 0. 8139--1. 08711, x^2 =0. 6869,P=0. 4072）, EMB （OR=0. 9222, 95%CI=0. 7205-1. 1804, x^2 =0. 4140,P= 0. 5199）, Ofx （OR=0. 9624,95%CI=0. 6923--1. 3378, x^2 =0. 0520,P=0. 8196）, Km （OR= 1. 1666,95%CI= 0. 7624-1. 7852, x^2 = 0. 5049,P= 0. 4774）, respectively; and we did not find any associations between Beijing gen- otype strains and monodrug resistant to INH （OR=0. 9955,95%CI=0. 7206--1. 3753, x^2 =0. 0007,P=0. 9783）, RFP （OR=0. 9615,95%CI=0. 4880--1. 8944, ）x^2 =0. 0129,P=0. 9096）, EMB （OR=0. 5533,95%CI=0. 2023-1. 5136, x^2=1. 3675,P=0. 2422）, Ofx （OR=0. 8445,95%CI=0. 3965--1. 7984, x^2=0. 1926,P=0. 6608）, Km （OR= 1. 7779,95%CI=0. 4440- 7. 1203, X2 = 0. 6791, P = 0. 4099）, respectively; also, there were no significant associations between Beijing genotype strains and multidrug resistance （MDR） （OR = 0. 9884,95%CI= 0. 7594-1. 2284, x^2 =0. 0110,P=0. 9166）, extensively drug resistance （XDR） （OR= 1. 1502,95%CI=0. 5372-2. 4626, x^2=0. 1300,P=0. 7185）TB. Conclusion Beijing genotype strains are highly prevalent in China, there are no sig- nificant associations with age or sex, and there are no significant associations between Beijing genotype strains and drug resistance.
出处
《中国防痨杂志》
CAS
2015年第8期836-842,共7页
Chinese Journal of Antituberculosis
基金
基金项目：“十二五”国家重大科技专项（2014ZX1003001-001）
关键词
结核分枝杆菌
基因型
抗药性
细菌
患病率
Mycobacterium tuberculosis
Genotype
Drug Resistance, Bacterial
Prevalence
