The clinical study on treatment of old patient with pulmonary tuberculosis by detecting drug resistance genes in Mycobacterium tuberculosis.

Objective To investigate drug resistance of Mycobacterium tuberculosis in old patients with pulmonary tuberculosis, To evaluate the clinical application value of detecting drug resistance genes in Mycobacterium tuberculosis. Methods Analyzing and comparing the results of mutation of genes and drug sensitive test in 117 M.tuberculosis clinical isolates by PCR SSCP detecting the rPOB?katG ?rPSL?PncA and embB resistance genes in M. tuberculosis and the proportion method on Lowenstein Jensen medium .Evaluating the clinical treatment effect.Results The rates of drug resistance to RFP? INH? SM ?PZA and EB were 82.1%?71.7%?63.2%?51.2%和35.0% respectively,. The gene mutation rate of RFP?INH?SM?PZA and EB were 72.8%?64.9%?59.8%?41.0%和30.7% respectively, The gene mutation was in relation with drug resistance level of M. Tuberculosis. The gene mutation rate was higher in high concentration drug resistance isolated strains than that in low concentration drug resistance isolated strains. The clinical cure rate of MDR TB 1n six months by drug sensitive test and by PCR SSCP was 54.8% and 62.8% ( P 0.05) , The treatment effect was satisfactory. Conclusions The method of detecting resistance genes of Mycobacterium tuberculosis was a new explore in guiding treatment, PCR SSCP is a sensitive and specific method for rapid detecting rpoB?katG?rpsL?pncA and embB genes mutations of M.TB. It might become good method for clinical management.