Investigation of the invasion of multidrug and extensively drug-resistant Mycobacterium tuberculosis in Asian countries

我们收集了结核分枝杆菌临床分离株，并分析了利福平和异烟肼耐药与基因突变的相关性，重点是缅甸，孟加拉国和尼泊尔，这些国家的多重和广泛耐药结核病的调查是不够的。在缅甸，利福平耐药M.结核分枝杆菌katG基因编码区和inhA基因调控区的基因型与异烟肼耐药分枝杆菌katG基因编码区和inhA基因调控区的基因型相似。结核病分别为71.3%和72.5%。相反，在其他两个国家观察到更高的相关性。利福平和异烟肼耐药M.结核病在孟加拉国分别为95.0%和94.5%，在尼泊尔分别为97.2%和93.8%。此外，7株广泛耐药M.在孟加拉国，分别从218个多药耐药菌株中发现了结核病。在尼泊尔，分别从109株多重耐药菌株中发现了13株广泛耐药结核病。所有这些分离株携带突变的rrs和gyrA或gyrB卡那霉素和氟喹诺酮耐药，分别。由于耐药与基因突变之间的相关性在不同国家之间存在差异，因此在引入基于基因的药物敏感性测试之前阐明耐药相关基因似乎很重要。

We have collected clinical isolates of Mycobacterium tuberculosis and analyzed the correlation between rifampicin and isoniazid resistance and gene mutations by focusing on Myanmar, Bangladesh and Nepal those where the survey of multi and extensively drug-resistant tuberculosis is not sufficient. In Myanmar, mutation rate for ropB encoding region of rifampicin resistant M. tuberculosis and that in katG encoding and inhA regulatory region of isoniazid resistant M. tuberculosis were 71.3 and 72.5%, respectively. On the contrary, higher correlations were observed in other two countries. Those for rifampicin and isoniazid resistant M. tuberculosis were 95.0 and 94.5 %, respectively, in Bangladesh and 97.2 and 93.8 %, respectively, in Nepal. In addition, seven extensively drug resistant M. tuberculosis were found from 218 multi drug-resistant strains, respectively, in Bangladesh. Thirteen extensively drug.resistant tuberculosis were found from 109 multi drug-resistant strains, respectively, in Nepal. All of these isolates carried mutations in rrs and gyrA or gyrB for kanamycin and fluoroquinolone resistance, respectively. As correlations between drug resistance and gene mutations were different between countries, the elucidation of drug resistance associating genes before introducing gene based drug susceptibility tests seemed to be important.