Molecular Epidemiology and Clinical Characteristics of Drug-Resistant Mycobacterium tuberculosis in a Tuberculosis Referral Hospital in China

BackgroundDespite the large number of drug-resistant tuberculosis (TB) cases in China, few studies have comprehensively analyzed the drug resistance-associated gene mutations and genotypes in relation to the clinical characteristics of M. tuberculosis (Mtb) isolates.Methodology/Principal FindingsWe thus analyzed the phenotypic and genotypic drug resistance profiles of 115 Mtb clinical isolates recovered from a tuberculosis referral hospital in Beijing, China. We also performed genotyping by 28 loci MIRU-VNTR analysis. Socio-demographic and clinical data were retrieved from medical records and analyzed. In total, 78 types of mutations (including 42 previously reported and 36 newly identified ones) were identified in 115 Mtb clinical isolates. There was significant correlation between phenotypic and genotypic drug resistance rates for first-line anti-TB drugs (PConclusions/SignificanceOur study provided information on novel potential drug resistance-associated mutations in Mtb. In addition, the genotyping data from our study suggested that enforcement of the implementation of genotyping in diagnostic routines would provide important information for better monitor and control of TB transmission.

【背景】尽管我国耐药结核病（Tuberculosis，TB）病例数量庞大，但目前鲜有研究结合结核分枝杆菌（Mycobacterium tuberculosis，Mtb）临床分离株的临床特征，对其耐药相关基因突变及基因型展开全面分析。
【方法与主要结果】本研究针对我国北京某结核病转诊医院分离获得的115株结核分枝杆菌临床分离株，分析其表型与基因型耐药特征；同时采用28位点MIRU-VNTR（Mycobacterial Interspersed Repetitive Units-Variable Number Tandem Repeats）分型技术进行基因分型。研究从病历档案中调取社会人口学与临床资料并进行分析。最终在115株临床分离株中，共鉴定出78种突变类型（其中42种为既往已报道的突变，36种为新发现的突变）。一线抗结核药物的表型耐药率与基因型耐药率之间存在显著相关性（P
【结论与意义】本研究揭示了结核分枝杆菌中潜在的新型耐药相关突变信息。此外，本研究的基因分型数据表明，在临床诊断常规流程中推广基因分型技术的应用，可为结核病传播的监测与防控工作提供重要依据。