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首页> 外文期刊>International journal of infectious diseases : >Additional drug resistance for Mycobacterium tuberculosis during turnaround time for drug-susceptibility testing in China: A multicenter observational cohort study
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Additional drug resistance for Mycobacterium tuberculosis during turnaround time for drug-susceptibility testing in China: A multicenter observational cohort study

机译：中国药物易感性测试周转时间的结核分枝杆菌的额外耐药性：多中心观察队列研究

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Background Although phenotypic drug susceptibility testing (DST) of Mycobacterium tuberculosis (Mtb) takes up to 6–8 weeks, little is known about how drug susceptibility is affected during this period. Methods We performed a prospective cohort study to investigate the development of drug resistance (DR) during turnaround time (TAT), including 359 pulmonary tuberculosis (PTB) patients with a baseline DST result of an Mtb isolate collected at TB diagnosis and a follow-up DST result of an Mtb isolate collected when baseline DST result was available between 2013 and 2018. Whole-genome sequencing (WGS) was used to differentiate between acquired drug resistance, exogenous reinfection, and mixed infection. Results Among the studied patients, during TAT for DST, 116 (32.3%) developed DR to four first-line drugs (rifampicin, isoniazid, pyrazinamide, ethambutol). Among 116 pairs of isolates included for WGS, 21 pairs were classified as acquired drug resistance with single nucleotide polymorphisms (SNPs) differences less than 12. Four pairs with an intermediate SNPs differences displayed minor differences in related genotypes and were assessed as mixed infection. The remaining 91 pairs had high SNPs differences consistent with exogenous reinfection. Conclusions The exogenous reinfection of drug-resistant strains played a vital role in the development of DR of Mtb isolates during TAT for DST, highlighting the need for both rapid DST methods and improved infection control.
机译：背景技术虽然结核分枝杆菌（MTB）的表型药物易感性测试（DST）占6-8周，但关于在此期间的影响受药物易感性的影响很少。方法采用预期队列研究，调查周转时间（TAT）期间耐药性（DR）的发展，包括359例肺结核（PTB）患者在结核病诊断和随访中收集的MTB孤立的基线DST结果在2013年和2018年在基准直线DST结果可用时收集MTB孤立的DST结果。全基因组测序（WGS）用于区分获得的耐药性，外源性再感染和混合感染。研究患者在DST的TAT期间，116（32.3％）开发了DR到四种一线药物（利福平，异烟肼，吡嗪酰胺，乙胺丁醇）。在包括用于WGS的116对分离物中，将21对分类为具有小于12的单核苷酸多态性（SNP）差异的获得药物抗性，其具有中间SNPS差异的四对与中间SNPS差异显示出相关基因型的微小差异，并被评估为混合感染。剩下的91对具有高SNPS差异与外源性重新感染一致。结论耐药菌株的外源性重新切割在DST的TAT期间MTB分离株DR的发育中发挥了至关重要的作用，突出了快速DST方法的需求和改善的感染控制。

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