Studies Of Drug Resistance Of Mycobacterium And Resistance Mechanism In The First Hospital Of Jiaxing,2016?2017

Objective To investigate Mycobacteriumth(TB)species and drug resistance of mycobacterium which was isolated from 2016~2017 in The First Hospital of Jiaxing,studing drug resistance related proteins of Mycobacterium tuberculosis(MTB)by Comparative proteomics,providing the basis for drug-resistant MTB prevention and control.Methods 1646 spetum from tuberculosis patients between January 2016 and December2017 were identified the species and the drug resistance of 4 kinds of anti-tuberculosis drugs susceptibility tests was analyzed by absolute concentration methods.The proteins extracted from Different clinical drug resistant MTB strains and susceptible MTB strains were analyzed by two-dimensional polyacrylamide gel electrophoresis.Protein spots remarkly increased in Different clinical drug resistant MTB strains were digested in gel by enzyme and the mass of generated peptides were measured by matrix assisted laser desorption ionization time of flight mass spectrometry(MALdI-TOF-MS).The date obtained from peptide mass fingerprinting were used in protein database search.These genes of all strains were sequenced.Results 1123 strains of MTB were checked out in 1646 tuberculosis patients with68.23%(1123/1646)MTB detection rate.The total resistance rate of MTB was17.10%(192/1123),multi-drug-resistant rate was 3.38%(38/1123),mono-drug-resistant rate was 9.97%(112/1123),poly-drug-resistant rate was 3.74%(42/1123).Drug resistance rates ranked from high to low as isoniazid(INH 10.86%,122/1123),streptomycin(SM9.71%,109/1123),rifampicin(RFP 3.83%,43/1123),ethambutol(EMB 3.38%,38/1123).Nitial multi-drug-resistant rate and acquired multi-drug-resistant rate was 2.43%(22/907)and 7.41%(16/216)respectively,and acquired drug resistance rate was higher than the initial drug resistance rate,there was a statistically significant difference(?~2=13.24,?<0.05).145 Non-tuberculosis mycobacteria(NTM)were isolated with8.09%(145/1646)NTM detection rate.NTM detection rate rised with the increse of age.Male accounted for 66.90%(97/145).The detection rate of NTM were 7.05%(88/1249)for new patients and 14.36%(57/397)for retreatment patients,the difference was statistically significan(?2=20.05,?<0.05).The total resistance rate of NTB was91.03%(132/145).The monoresistance rate to INH was the highest(88.97%,129/145),followedbySM(79.31%,115/145),andRFP(66.90%,97/145),andEMB(51.72%,75/145).In all protein spot differences,5 protein spots were upregulated inisoniazid-resistant MTB strains and identified as Rv0444c,Rv1446c,Rv3146,Rv3002c and Rv2159c by(MALdI-TOF-MS).Conclusion Mycobacterium tuberculosis resistant rate in The First Hospital of Jiaxing was lower than the national epidemiological survey in 2010,showing prevention and control strategy of MTB worked slightly over the last two years.The NTM infection rate was given priority to elderly and the drug-resisting rate was high,so early dianogsis and treatment of NTM were needed.5 protein spots(Rv0444c,Rv1446c,Rv3146,Rv3002c and Rv2629c)might be associated with drug resistance mechanism by Comparative proteomics.