To analyse the rifampicin and isoniazid resistance patterns and mutation sites in 793 clinical isolates of Mycobacterium tuberculosis from Garze Tibetan Autonomous Prefecture, Sichuan Province, collected between September 2018 and August 2025, so as to provide scientific basis for local tuberculosis prevention and control.
DNA microarray gene chips were used to perform rapid molecular detection of rifampicin and isoniazid resistance genes in collected M. tuberculosis isolates. The drug resistance and mutation of resistance genes in the region were analyzed, and chi square analysis was used to compare the drug resistance of different genders, ages, and agricultural landscape areas.
The overall resistance rate of 793 cases of Mycobacterium tuberculosis to rifampicin and isoniazid was 18.16%, with a rifampicin resistance rate of 12.99%, isoniazid resistance rate of 10.7%, and multidrug resistance rate of 5.55%. According to statistical analysis, there was no significant difference in drug resistance rates between patients of different genders. The overall drug resistance rate (21.67%), isoniazid resistance rate (14.28%), and multidrug resistance rate (6.90%) were highest in patients aged 0-<20, and the rifampicin resistance rate (14.56%) was highest in the 40-<60 age group. Differences in overall resistance, rifampicin resistance, isoniazid resistance and multidrug resistance between age groups were not statistically significant. Drug resistance rates were higher in semi-agricultural/semi-pastoral areas than in purely agricultural or pastoral areas. However, no statistically significant differences were observed between overall drug resistance and rifampicin resistance. A statistically significant difference was found between isoniazid resistance and multidrug resistance(χ2=9.089,13.680,P<0.05). The predominant rifampicin resistance mutation site was rpoB531(C->T) (33.01%), followed by 516(G->T) (25.24%) and 511(T->C) (18.45%). Isoniazid resistance was predominantly mediated by katG gene mutations (92.94%), comprising katG315(G->C) (84.71%) and katG315(G->A) (8.24%), while inhA gene mutations accounted for 8.24%. Multidrug resistance was predominantly mediated by rpoB(516(G->T) katG(315(G->C) mutations, accounting for 52.27%.
Rifampicin and isoniazid resistance in tuberculosis cases from Garze Tibetan Autonomous Prefecture is severe. Resistance is more pronounced in the 0-<20 age group compared to other age cohorts, and is more prevalent in semi-agricultural/semi-pastoral areas than in purely agricultural or pastoral regions. Resistance mutations predominantly involve high-level resistance sites for both rifampicin and isoniazid. The region requires enhanced tuberculosis drug resistance testing and detection, strengthened standardised treatment and management of patients, and reduced generation and transmission of drug-resistant tuberculosis, and pay special attention to tuberculosis drug resistance prevention and control among low-age groups and people living in semi-agricultural and semi-pastoral areas.
| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |