尼日利亚西北部索科托耐多药结核分枝杆菌的流行和分子定位

S. Hudu, A. Jimoh, Y. Mohammed
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摘要

背景:耐多药结核病(MDR-TB)的出现对尼日利亚的结核病控制工作构成重大威胁。尼日利亚每年记录57万新发结核病病例,它是世界上结核病负担最重的国家之一,也是耐多药结核病十大国家之一。本研究旨在确定耐多药患病率、系统发育分析、分子定位以及耐多药患病率与人口统计学数据之间的联系。方法:连续招募100例结核病患者。采用Lowenstein-Jensen (LJ)培养基比例法进行药敏试验。采用常规聚合酶链反应(PCR),扩增rrs基因并测序。采用多种序列比对技术将PCR产物序列与GenBank检索的参考序列进行比对。结果:利福平(RIF)耐药占29%(22.75),乙胺丁醇耐药占20%(15.75),异烟肼(INH)耐药占28%(21.75)。20%(15.75%)的样本对RIF和INH耐药。在892核苷酸位置,4株(31%)含有G-A转位,rrs基因中最常见的突变为S531L(80%, 12.15)。系统发育分析表明,其中3个Sokoto分离株在地理亲缘性方面与来自伊朗、德国、中国和苏丹的参考分离株密切相关。结论:获得的数据显示,获得性耐药是索科托建立耐多药结核病的一个主要因素,这可能是由于结核病患者服药依从性差或治疗不良所致。
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Prevalence and Molecular Mapping of Multidrug-resistant Mycobacterium tuberculosis in Sokoto, North-Western Nigeria
Background: The emergence of multidrug-resistant tuberculosis tuberculosis (MDR-TB) poses a significant danger to Nigeria’s TB control efforts. Nigeria records 570000 new TB cases each year, and it is one of the world’s greatest TB-burden countries as well as one of the top ten countries with MDR-TB. This study aimed to determine the MDR prevalence, phylogenetic analysis, and molecular mapping as well as the link between MDR prevalence and demographic data. Methods: The study comprised 100 TB patients recruited consecutively. The proportion method on Lowenstein-Jensen (LJ) medium was used for drug susceptibility testing. Conventional polymerase chain reaction (PCR) was used, and the rrs genes were amplified and sequenced. Multiple sequence alignment techniques were used to compare the PCR product sequences to reference sequences retrieved from GenBank. Results: Rifampicin (RIF) resistance was found in 29% (22.75), ethambutol resistance was found in 20% (15.75), and isoniazid (INH) resistance was found in 28% (21.75). Further, RIF and INH resistance were found in 20% (15.75) of the samples. At nucleotide position 892, four isolates (31%) contained a G-A transition, and the most prevalent mutation found in the rrs gene was S531L (80%, 12.15). The phylogenetic analysis indicated that three of the Sokoto isolates are closely linked to reference isolates from Iran, Germany, China, and Sudan in terms of geographical relatedness. Conclusions: The obtained data revealed that acquired resistance is a major factor in the establishment of MDR-TB in Sokoto, which could be owing to poor adherence to medication or poor treatment of TB patients.
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