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| Distribution of Tuberculosis Drug Resistance Genes in Patients with Hepatitis B Complicated with Mycobacterium Tuberculosis Infection |
| MENG Ying, et al |
| Tangdu Hospital of Air Force Military Medical University, Shaanxi Xi'an 710038, China |
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Abstract Objective: To examine the M. tuberculosis strain diversity and describe the frequency and molecular mechanisms of resistance against first-line TB drugs in TB/HBV co-infected patients. Methods: A total of 100 strains of Mycobacterium tuberculosis from TB/HBV co-infected patients were analyzed retrospectively, among which Beijing strain was the most common (49%), followed by EAI strain (35%), and a few strains included Haarlem(2.0%), LAM(1.0%), MANU(3.0%) and T(4.0%). All strains were isolated from sputum and pleural effusion samples of patients from 2014 to 2018. Drug susceptibility testing, spoligotyping and 24-locus Mycobacterial Interspersed Repetitive Unit (MIRU-24 typing) were performed, and the rpoB, katG, inhA and inhA promoter, rpsL, rrs and embB genes were sequenced in all drug resistant isolates identified. Results: In total, 42/100 (42.0%) strains showed drug resistance; 9 (9.0%) were multi-drug resistant (MDR). Resistance rates were 25.0% (25/100) to isoniazid, 10.0% (10/100) to rifampicin, 5.0% (5/100) to ethambutol, and 40.0% (40/100) to streptomycin. Among rifampicin-resistant strains, 90% (9/10) of the isolates with rifampicin resistance had mutations in the RRDR (codons 507-533). Among isoniazid-resistant strains, mutations were found in 100% and 21% of katG and inhA (including the inhA promoter), respectively; their multidrug resistance was mainly associated with the Ser315Thr mutation in the katG gene (7/9, 77.8%). 59.5% of the strains with resistance belonged to the Beijing spectrum, and 66.7% of the MDR strains belonged to the Beijing spectrum. Conclusion: Nearly half (42%) of M. tuberculosis isolates from TB/HBV co-infected patients are drug-resistant strains, among which Beijing lineage is the main strain.
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[1] 蒋福明,程书权,黄成军,等.轻度慢性乙型肝炎合并肺结核患者抗病毒治疗82病例对照研究[J].世界华人消化杂志,2017,25(34):3072-3079.
[2] Chen L,Bao Dujing,Gu Lin,et al.Co-infection with hepatitis B virus among tuberculosis patients is associated with poor outcomes during anti-tuberculosis treatment[J].Bmc Infect Dis,2018,18(1):295.
[3] 吴碧彤,邝浩斌,刘志辉,等.标准耐多药结核病化疗方案中是否对吡嗪酰胺耐药的疗效对比研究[J].中国防痨杂志,2019,41(4):447-451.
[4] 陈杏,李雨晴,万李,等.中国西南地区结核分枝杆菌临床分离菌株一线药物耐药状况调查[J].中国人兽共患病学报,2017,33(4):300-304.
[5] Singh V,Dziwornu G A,Chibale K.The implication of mycobacterium tuberculosis-mediated metabolism of targeted xenobiotics[J].Nat Rev Chem,2023,7(5):340-354.
[6] 刘厚明,陈珊,黄莎莎,等.某院结核分枝杆菌利福平和异烟肼耐药基因特征[J].中国感染控制杂志,2018,17(6):36-41.
[7] Xiang X,Gong Z,Deng W,et al.Mycobacterial ethambutol responsive genes and implications in antibiotics resistance[J].Drug Target,2021,29(3):284-293.
[8] Holt KE,Mcadam,Paul,et al.Frequent transmission of the Mycobacterium tuberculosis Beijing lineage and positive selection for the EsxW Beijing variant in Vietnam[J].Nat Genet,2018,50(6):849-856. |
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2024, Vol. 30 
