Analysis on the present state in multi-drug resistant Mycobacterium tuberculosis infection and its clinical background in China

中国与中山大学第三附属医院、广州市胸科医院合作，对广州市耐多药肺结核现状进行了调查。2008年胸科医院耐多药肺结核和广泛耐药肺结核分别为16.7%和2.0%，9.1%和0。2009年为9%，2009年为13.5%和0。2010年分别为3%，这表明在研究期间广泛耐药结核病有下降的趋势，但耐多药结核病没有变化。对50株MDR-TB和5株XDR-TB的耐药基因rpoB、Kat G、inhA和ahpC进行了测序，突变频率分别为90%、63%、22%和6%。此外，我们通过测量BMI、血清白蛋白水平、WBC计数、T细胞和NK细胞比例、CD4/CD8比值和外周血淋巴细胞对TB抗原的反应性来分析这些患者的宿主因素，发现药物敏感和MDR-TB之间没有显著差异。

We investigated the present state in multi-drug resistant tuberculosis (TB)in Guangzhou City, Guangdong Province, China by collaborating with the Third Affiliated Hospital of Sun Yat-Sen University and Guangzhou Chest Hospital. In the Chest Hospital, the proportion of MDR-TB and extensively drug-resistant (XDR)-TB was 16. 7%and 2. 0%in 2008, 9. 1%and 0. 9%in 2009 and 13. 5%and 0. 3%in 2010, respectively, which showed that XDR-TB tended to be decreased during the study period though no change in MDR-TB. We sequenced the drug resistance genes, rpoB, kat G, inhA and ahpC, in 50 strains of MDR-TB and 5 strains of XDR-TB, and mutation was detected at 90%, 63%, 22%and 6%, respectively. In addition, we analyzed the host factors in these patients by measuring BMI, serum albumin levels, WBC counts, proportion of T and NK cells, CD4/CD8 ratio and reactivity of peripheral blood lymphocytes to TB antigens, and we did not find any significant difference between drug-sensitive and MDR-TB.