结核分枝杆菌复合体:沙特阿拉伯阿卜杜勒阿齐兹国王大学医院一线抗结核药物的检测和耐药性模式

A. Jiman-Fatani, D. El-Hossary, Rehab A. Eltahlawi
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引用次数: 2

摘要

结核病(TB)仍然是全世界发病率和死亡率的主要原因。持续监测药物敏感性有助于确定抗结核药物的治疗方案。采用Versa TREK技术比较了基因Xpert PCR与液体培养基检测结核分枝杆菌复合体(MTBC)的敏感性。2013年1月至2014年6月测定了沙特阿拉伯吉达阿卜杜勒阿齐兹国王大学医院(KAUH)的结核病耐药率、模式和类型。共纳入101例结核患者,其中沙特结核患者43例,非沙特结核患者58例。检测到的所有电阻均为初级电阻。AFB阴性样品和AFB +1、+2、+3、+4阳性样品的MTBC检测灵敏度分别为29.4%、80%、87.5%、77.8%和100%。afb阳性标本MTBC检出率为88.1%,afb阴性标本MTBC检出率为29.9%。afb阳性样品的Versa Trek检测时间为15.01±7.32 d, afb阴性样品的Versa Trek检测时间为26.63±6.7 d。MTBC对吡嗪酰胺的耐药率为13.86%,其次是链霉素(7.9%)、利福平(3.96%)和异烟肼(3.96%)。吡嗪酰胺、利福平和异烟肼的单耐率分别为11.88%、1.98%和0.99%。耐多药率为1.98%,耐药率为24.75%。沙特和非沙特结核病患者在抗结核药物耐药方面无显著差异。
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Mycobacterium tuberculosis complex: Detection and patterns of resistance to the first line anti-TB drugs at the King Abdulaziz University Hospital, Saudi Arabia
Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. Continued surveillance of drug susceptibility help determining treatment regimen by anti-tuberculous drugs. Gene Xpert PCR sensitivity was compared to the liquid culture media by Versa TREK for detecting Mycobacterium tuberculosis complex(MTBC). Rates, patterns and types of anti-tuberculosis drug- resistance atKing Abdulaziz University Hospital (KAUH), Jeddah, KSA were determined from January 2013 to June 2014.A total of 101 tuberculous patients were included, 43 Saudi tuberculous patients and 58 non-Saudi tuberculous patients. All resistances detected were primary resistances. PCR Sensitivities for detection of MTBC were 29.4%, 80%, 87.5%, 77.8% and 100% in AFB-negative samples and AFB +1,+2,+3 and +4 positive samples respectively. MTBC percentage detected by PCR was 88.1% in AFB-positive samples and 29.9% in AFB-negative ones. Versa Trek detection time was 15.01±7.32 days in AFB-positive samples and 26.63±6.7 days in AFB-negative ones. MTBC pyrazinamide resistance was (13.86%), followed by streptomycin (7.9%), rifampicin (3.96%) and isoniazid (3.96%). Mono-resistance percentages to pyrazinamide, rifampicin and isoniazid were 11.88%, 1.98% and 0.99% respectively. MDR-TB were 1.98% and anti-TB resistance percentage was 24.75%. There was no significant difference between Saudi and non-Saudi tuberculous patients regarding anti- tuberculous drugs resistance.
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