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| Analysis of resistant genetic mutations and characteristics of multidrug-resistant/rifampicin-resistant Mycobacterium tuberculosis in Wenzhou |
| WU Lianpeng1, 2, XU Ke1, 2, HE Guiqing2, 3. |
| 1.Department of Clinical Laboratory Medicine, the Dingli Clinical Institute of Wenzhou Medical University, Wenzhou Central Hospital, Wenzhou 325000, China; 2.Key Laboratory for Diagnosis and Treatment of New and Recurrent Infectious Diseases of Wenzhou, Wenzhou 325000, China; 3.Department of Infectious Disease, the Dingli Clinical Institute of Wenzhou Medical University, Wenzhou Central Hospital, Wenzhou 325000, China |
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WU Lianpeng,XU Ke,HE Guiqing. Analysis of resistant genetic mutations and characteristics of multidrug-resistant/rifampicin-resistant Mycobacterium tuberculosis in Wenzhou[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(4): 305-310.
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Abstract Objective: To analyze by whole genome sequencing (WGS) the drug resistance of multi-drug resistant/rifampicin-resistant Mycobacterium tuberculosis (MDR/RR-MTB) in Wenzhou in order to provide reference for the prevention and treatment of drug-resistant tuberculosis. Methods: The strains and clinical data of 54 patients with MDR/RR-TB treated in Wenzhou Central Hospital from January 2021 to September 2022 were collected and WGS was performed. The drug resistance of strains to 15 kinds of anti-tuberculosis drugs was analyzed. Simultaneously, a string diagram of bacterial resistance and a heat map were used to visualize drug resistance spectrum of all strains and pre-XDR-MTB/XDR-MTB strains, respectively. Results: Of 54 patients,75.93% were male and 50.00% over 45 years old; Wenzhou local residents accounted for 83.33%, non-fixed occupation 92.59%, and retreatment accounted for 40.74% of the treatment types. There was significant difference in sex, age, household registration and occupation (P<0.05), but there was no significant difference in the type of treatment (P>0.05). The drug resistance rate of 54 strains to drugs ranking from high to low was rifampicin (100.00%, 54/54), isoniazid (83.33%, 45/54), streptomycin (50.00%, 27/54), ethambutol (38.89%, 21/54), pyrazinamide (35.19%, 19/54), fluoroquinolones (24.07%, 13/54), prothionamide (24.07%, 13/54), and kanamycin (9.26%, 5/54), amikacin (9.26%, 5/54), capreomycin (9.26%, 5/54), para-aminosalicylic acid (7.41%, 4/54), linezolide (1.85%, 1/54), did not produce resistance to bedaquiline, cycloserine and chlorfazimine. A total of 65 types of gene mutations were detected, and mutations were most common in katG_S315T (77.78%, 35/45), rpoB_S450L (48.15%, 26/54), embB_M306V (52.38%, 11/21),rpsL_K43R (77.78%, 21/27), and gyrA_D94G (30.77%, 4/13). There were 3 XDR-TB strains (5.56%, 3/54) and 10 Pre-XDR-TB strains (18.52%, 10/54) were detected. Conclusion: Most of the MDR/RR-TB patients in Wenzhou are local middle-aged and elderly men with no fixed occupation, and the proportion of retreatment is high. The resistance rate of the strains to first-line anti-tuberculosis drugs, fluoroquinolones and prothionamide is high, mainly to katG, rpoB, embB, rpsL, pncA and gyrA gene mutations, but low to berdaquinoline, linezolid, cycloserine and chlorfazimine. The proportion of Pre-XDR-TB in MDR/RR-TB is high, so clinical treatment should refer to the results of drug sensitivity test for the sake of reasonable drug use.
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Received: 16 January 2023
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PAN Ya’nan, ZHOU Jinhui, ZHANG Manman, MAO Huining, LI Siyu, HAN Hao, YUAN Xiang, TU Huixi, LIN Li.. Pathogenic bacteria distribution and antimicrobial susceptibility in children with bloodstream infections[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2023, 53(5): 392-398. |
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