Influencing factors of rifampicin resistance and analysis of rpoB gene mutation sites in Mycobacterium tuberculosis
- Author:
LIU Haiqing
;
ZHANG Wei
- Publication Type:Journal Article
- Keywords:
Mycobacterium tuberculosis;
rifampin;
gene;
mutation
- From:
China Tropical Medicine
2024;24(1):96-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the influencing factors of rifampicin resistance and the mutation frequency and distribution of rpoB gene in Mycobacterium tuberculosis, and to analyze the mutation characteristics of resistance-determining region (RRDR), so as to provide reliable laboratory evidence for the epidemic trend, prevention, and treatment of rifampicin-resistant tuberculosis. Methods A total of 312 patients with pulmonary tuberculosis who were treated in the Second People's Hospital of Fuyang from March 2019 to December 2021 were selected. After Xpert MTB/RIF and liquid drug susceptibility test, 156 patients with rifampicin-resistant pulmonary tuberculosis were selected as the rifampicin-resistant group, and 156 patients with non-drug-resistant pulmonary tuberculosis were selected as the general group. The general information and rpoB gene mutation of the two groups of patients were analyzed. Results Among the 312 cases of pulmonary tuberculosis patients, the presence of complications, retreatment, self-medication, non-standard medication, treatment interruption, and low awareness of transmission routes were significantly higher in the rifampicin-resistant group than in the general group, and the differences were all statistically significant; logistic regression analysis showed that comorbidity and retreatment were the risk factors of rifampicin resistance. Among the 156 rifampicin-resistant specimens, 152 (97.44%) had single-gene mutations and 4 (2.56%) had double-gene mutations. The highest single-gene mutation was ProbeE, followed by ProbeD; the double-gene mutations were D+E, followed by A+B; statistically significant differences were observed for ProbeE between the initial treatment and retreatment groups (χ2=3.97, P<0.05), while others showed no statistically significant differences; among 118 multidrug resistance mutations, ProbeE accounted for the highest proportion, followed by ProbeD; there were 38 cases of single rifampicin resistance, and the proportion of mutation sites from high to low was ProbeE and ProbeD; all 4 cases of double-gene mutations were MDR-TB; there were no statistically significant differences in mutation sites between MDR-TB and RR-TB. Conclusions Attention should be paid to pulmonary tuberculosis patients with comorbidities and retreatment patients, and timely intervention should be given to reduce the probability of rifampicin resistance. The rpoB gene mutations in rifampicin-resistant patients are mainly single-probe mutations, with no difference in the rpoB gene mutations sites between the rifampicin-resistant patients and multidrug-resistant patients.
Keywords: Mycobacterium tuberculosis; rifampin; gene; mutation
- Full text:202503061057527083918.Influencing factors of rifampicin resistance and analysis of rpoB gene mutation sites in Mycobacterium tuberculosis.pdf
