COVID-19 大流行期间洛阳市非老年结结核分枝杆菌播散及耐药特征：基于年龄分层的对比研究

刘进伟; 郭腾飞; 徐礼扬; 江涛; 高伟娜; 薛云; 王珍珍

微生物与感染 ›› 2025, Vol. 20 ›› Issue (2) : 65-78.

论著

COVID-19 大流行期间洛阳市非老年结结核分枝杆菌播散及耐药特征：基于年龄分层的对比研究

刘进伟¹,郭腾飞¹,徐礼扬²,江涛¹,高伟娜³,薛云³,王珍珍¹

作者信息 +

Transmission Dynamics and Drug Resistance Profile of Mycobacterium tuberculosis complex in Non-elderly Populations During the COVID-19 Pandemic: An Age-stratified Comparative Study in Luoyang

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文章历史 +

摘要

摘要：本研究旨在探讨年龄分层视角下COVID-19大流行期间洛阳市结核病定点医疗机构内就诊的非老年人群（<60岁）结核分枝杆菌复合物（Mycobacterium tuberculosis complex，MTBC）的播散及分子耐药特征。2020-2022年期间，对16,631例患者的痰标本（其中非老年组9,990例）行实时荧光 PCR检测 MTBC 特异性插入序列 IS 6110，并对阳性标本采用熔解曲线技术分析，检测异烟肼（isoniazid，INH）、利福平（rifampin，RFP）、链霉素（streptomycin，SM）和乙胺丁醇（ethambutol，EMB）的分子耐药性。对实验结果行年龄分层对比，进一步揭示非老年人群的MTBC播散及耐药特点。结果显示，非老年人群MTBC检出率（15.9% vs. 13.8%）及总耐药率（27.1% vs. 20.9%）均显著高于老年组（P < 0.001）。亚组分析表明，非老年群体中，男性、复治和主城区群体为携带 MTBC及耐药的高负担人群。多重耐药结核病（multidrug-resistant tuberculosis，MDR-TB）和多耐药结核病（poly-resistant tuberculosis，PDR-TB）的流行模式分别以MDR3（INH + RFP + SM）和PDR2（INH + SM）为主，检出率分别为4.8%（77例）和2.3%（37例）。研究表明，非老年人群（<60岁）是本地区结核病传播和耐药发展的关键群体，尤以男性、复治患者和主城区人群风险更为突出。建议针对该群体行精准结核负担监测，结合年龄分层特征优化全生命周期的防控策略，为 COVID-19 后时代的结核病精准防控提供科学依据。

Abstract

Abstract：This study aimed to investigate the dissemination and molecular drug resistance characteristics of Mycobacterium tuberculosis complex (MTBC) among non-elderly populations (<60 years old) attending tuberculosis-designated medical institutions in Luoyang during the COVID-19 pandemic from an age-stratified perspective. Sputum specimens from 16,631 patients (9,990 in the non-elderly group) at Luoyang Infectious Disease Hospital from 2020 to 2022 were analyzed using real-time fluorescence PCR to detect the MTBC-specific insertion sequence IS6110. Melting curve technology was applied to positive specimens to assess molecular drug resistance to isoniazid (INH), rifampin (RFP), streptomycin (SM), and ethambutol (EMB). Age-stratified comparisons were conducted to further reveal the MTBC dissemination and drug resistance patterns in non-elderly populations. During 2020-2022, sputum specimens from 16,631 patients (9,990 in the non-elderly group) were subjected to real-time fluorescence PCR for detecting the MTBC-specific insertion sequence IS6110. For positive specimens, melting curve technology was used to analyze the molecular drug resistance to isoniazid (INH), rifampin (RFP), streptomycin (SM), and ethambutol (EMB). Age-stratified comparisons of the experimental results were performed to further reveal the MTBC dissemination and drug resistance characteristics in non-elderly populations. The results revealed that both MTBC detection rates (15.9% vs. 13.8%) and the overall drug resistance rate (27.1% vs. 20.9%) were significantly higher in non-elderly individuals compared to the elderly group (all P < 0.001). Subgroup analysis indicated that among non-elderly populations males, retreatment patients, and the main urban population were high-burden subgroups with MTBC and drug resistance. The epidemic patterns of multidrug-resistant tuberculosis (MDR-TB) and poly-resistant tuberculosis (PDR-TB) were predominantly characterized by MDR3 (resistance to INH + RFP + SM) and PDR2 (resistance to INH + SM), with detection rates of 4.8% (77 cases) and 2.3% (37 cases) respectively. The study showed that non-elderly populations (<60 years old) are key drivers of tuberculosis transmission and drug resistance development in this region, with males, retreatment patients, and urban residents facing particularly prominent risks. It is recommended to implement targeted tuberculosis burden monitoring for this group, optimize life-cycle prevention and control strategies based on age-stratified characteristics, and provide a scientific basis for precision tuberculosis control in the post-COVID-19 era.

导出引用

刘进伟郭腾飞徐礼扬江涛高伟娜薛云王珍珍. COVID-19 大流行期间洛阳市非老年结结核分枝杆菌播散及耐药特征：基于年龄分层的对比研究[J]. 微生物与感染. 2025, 20(2): 65-78

Transmission Dynamics and Drug Resistance Profile of Mycobacterium tuberculosis complex in Non-elderly Populations During the COVID-19 Pandemic: An Age-stratified Comparative Study in Luoyang[J]. Journal of Microbes and Infections. 2025, 20(2): 65-78

中图分类号： R378.91+1

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