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. 2020 Jan 22:2020:9871390.
doi: 10.1155/2020/9871390. eCollection 2020.

Analysis of Clinical Factors, Bacterial Genotyping, and Drug Resistance for Spinal Tuberculosis in South-Central China

Zheng Liu  1   2 , Weiwei Li  1   2 , Yilu Zhang  2 , Yunqi Wu  2 , Xiao Xiao  1   2 , Zhicheng Sun  1   2 , Yan Yang  1   2 , Wenkai Hu  1   2 , Xiyang Wang  1   2 , Hao Zeng  3   4
Affiliations

Analysis of Clinical Factors, Bacterial Genotyping, and Drug Resistance for Spinal Tuberculosis in South-Central China

Zheng Liu et al. Biomed Res Int. .

Abstract

Spinal tuberculosis (STB), which is the most frequent and serious form of skeletal TB, is seriously harmful to a patient's life. However, very little research has been conducted on clinical isolates of STB. The purpose of this study was to genotype clinical isolates of Mycobacterium tuberculosis (MTB) from patients with STB, investigate their drug resistance profiles, and determine whether the genotypes and drug resistance patterns share any relationships with the demographic and clinical features of the patients. Preliminary species identification of the MTB strains was performed using a TCH/PNB culture method and multilocus polymerase chain reactions. Of the specimens collected from 85 hospital in-patients with STB at Xiangya Hospital, China, the 56 culture-positive MTB strains we identified were genotyped by spoligotyping. The strains were tested for resistance to anti-tuberculosis drugs (ATDs), and the demographic and clinical features of the patients were analyzed in combination with the genotyping and drug resistance results. Of the 56, cases, 53 involved M. tuberculosis and 3 involved M. bovis. Spoligotyping revealed 27 Beijing-type cases and 29 nonBeijing cases. When patients with STB were relapsing or experiencing systemic toxicity signs/symptoms (STS), the Beijing MTB-type strains predominated (p < 0.05), but when the patients were receiving initial treatment or lacked STS, the nonBeijing type MTB strains dominated. The Beijing and nonBeijing types differed in their resistance patterns to 8 ATDs, and the resistance rate of the Beijing type was higher than that of the nonBeijing type (p < 0.05). The bacteriological features of STB, including genotype and drug resistance, shared close relationships with the clinical features of patients with STB. Our data provide a reference for the diagnosis and treatment of STB.

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Conflict of interest statement

The authors declare that they have no conflicts of interests.

Figures

Figure 1
Figure 1
Result interpretation reference diagram for multilocus PCR.
Figure 2
Figure 2
Spoligotyping fingerprints. Positive (interval existence) or negative (interval missing) hybridization results are represented by binary codes 1 and 0, respectively.
Figure 3
Figure 3
Cluster analysis diagram of the spoligotyping results for the 56 MTB strains.
See this image and copyright information in PMC

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