邬俊勇 黄韬 江光荣

*基金项目：2023年宜春市指导性科技计划项目（2023ZDJH2691）

【摘要】 目的：探究2019—2021年宜春地区结核分枝杆菌利福平耐药株基因型。方法：选择2019年1月—2021年12月于宜春市人民医院接受治疗的肺结核患者100例，采集所有患者痰液样本进行检测。分析结核分枝杆菌分离情况及耐药性，另分析利福平耐药株基因型。结果：100例患者中共分离出结核分枝杆菌47株，分离率为47.00%，2019、2020、2021年结核分枝杆菌分离率分别为33.33%、45.95%、54.76%。2019年分离出结核分枝杆菌7株，利福平、异烟肼、链霉素耐药发生率分别为42.86%、28.57%、28.57%；2020年分离出结核分枝杆菌17株，利福平、异烟肼、链霉素耐药发生率分别为58.82%、29.41%、11.76%；2021年分离出结核分枝杆菌23株，利福平、异烟肼、链霉素耐药发生率分别为60.87%、21.74%、17.39%。结核分枝杆菌对利福平耐药率最高。经rpoB基因测序可见27株利福平耐药株均发生rpoB基因变异，基因突变率为100%（27/27），突变基因位点主要位于509～533位。结论：2019—2021年宜春地区结核分枝杆菌感染率呈逐年上升趋势，结核分枝杆菌感染患者对利福平存在较高的耐药性，且rpoB基因位点突变的发生与利福平耐药间存在密切联系。

【关键词】 肺结核 结核分枝杆菌 利福平 耐药株 基因分型

Genotype Analysis of Mycobaterium Tuberculosis Rifampicin Resistant Strain in Patients in Yichun Area from 2019 to 2021/WU Junyong， HUANG Tao， JIANG Guangrong. //Medical Innovation of China， 2024， 21（13）： -120

[Abstract] Objective： To explore the genotype of Mycobaterium tuberculosis Rifampicin resistant strain in patients in Yichun area from 2019 to 2021. Method： A total of 100 patients with pulmonary tuberculosis who received treatment in Yichun People's Hospital from January 2019 to December 2021 were selected， and all patients' sputum samples were collected for detection. The isolation and resistance of Mycobaterium tuberculosis were analyzed， and the genotype of Rifampicin resistant strain were also analyzed. Result： A total of 47 strains of Mycobaterium tuberculosis were isolated from 100 patients， and the isolation rate was 47.00%. The Mycobaterium tuberculosis isolation rates in 2019， 2020 and 2021 were 33.33%， 45.95% and 54.76%， respectively. In 2019，

7 strains of Mycobaterium tuberculosis were isolated， and the incidence of Rifampicin， Isoniazid and Streptomycin resistance were 42.86%， 28.57% and 28.57%， respectively. In 2020， 17 strains of Mycobaterium tuberculosis were isolated， and the incidence of Rifampicin， Isoniazid and Streptomycin resistance were 58.82%， 29.41% and 11.76%， respectively. In 2021， 23 strains of Mycobaterium tuberculosis were isolated， and the incidence of Rifampicin， Isoniazid and Streptomycin resistance were 60.87%， 21.74% and 17.39%， respectively. The resistance rate of Mycobaterium tuberculosis to Rifampicin was the highest. rpoB gene sequencing showed that all 27 strains of Rifampicin resistant strain had rpoB gene mutation， the mutation rate was 100% （27/27）， and the mutation loci were mainly located at 509-533 positions. Conclusion： From 2019 to 2021， the infection rate of Mycobaterium tuberculosis in Yichun area shows an increasing trend year by year， and patients with Mycobaterium tuberculosis infection have high resistance to Rifampicin， and there is a close association between the occurrence of mutations in the rpoB gene locus and Rifampicin resistance.

[Key words] Pulmonary tuberculosis Mycobaterium tuberculosis Rifampicin Resistant strain Genotyping

First-author's address： Department of Laboratory， Yichun People's Hospital， Yichun 336000， China

doi：10.3969/j.issn.1674-4985.2024.13.027

结核分枝杆菌是导致结核病的重要病原菌，现已成为危害人类身体健康的严重问题，近年来，结核分枝杆菌感染率逐年上升。大量数据显示，每年约900万人发展为活动性结核病，约300万人发展为耐多药结核病[1-2]。由此可见，给予结核分枝杆菌感染的结核病患者积极治疗尤为重要。随着抗结核药物的……