结核耐药基因的基因芯片检测及临床应用

Evaluation and Clinical Application of Gene Chip Technology in Testing Mycobacterium tuberculosis Drug-Resistance Gene Type

目的:采用基因芯片技术对结核分枝杆菌中常见耐药基因rpoB、katG及inhA进行检测,以了解结核分枝杆菌的耐药情况,及基因芯片技术检测结核菌耐药基因的临床应用价值。方法:收集40例涂片抗酸染色阳性并经分枝杆菌菌种鉴定芯片鉴定为结核的样本进行结核耐药基因检测。结果:40例样本中,14例无法判读结果,占35%,检出26例,检出率为65%。其中,无突变的野生型21例,占52.5%;突变型5例,总突变率为12.5%;3例rpoB基因的531点单独突变(TCG→TTG),突变率为7.5%;2例katG基因的315点单独突变(AGC→ACC),突变率为5%。结论:结核耐药基因芯片试剂盒检测结核菌耐药基因时针对单个菌落,用痰样本直接检测耐药基因虽能简便快速地了解结核分枝杆菌的耐药情况,但会出现一些无法判读的结果,原因须进一步探讨。

Objective： The gene chip technology was used for detection of drug-resistance genes rpoB, katG and inhA of Mycobacterium tuberculosis, in order to understand the resistance of M.tuberculosis, and clinical application value of gene chip detection on tuberculosis drug-resistance gene. Methods： 40 positive cases after sputum smear acid-fast stain and Mycobacterium species identification chip were used for tuberculosis drug-resistance gene test- ing. Results： Sample of 40 cases, 14 cases（35%） could not be interpreted, 26 cases were detected, the detection rate of 65%. 21 detected cases were non-mutant wild type, accounting for 52.5%; other 5 of them were mutants, the total mutation rate was 12.5%. In mutant type, 3 of them had separate mutation in the codon 531 of rpoB gene（TCG→TTG）, the mutation rate was 7.5%; 2 had separate mutation in the codon 315 of katG gene（AGC→ACC）, the mutation rate was 5%. Conclusion： The drug-resistance gene chip kit is only for a single bacterium colony. Although for the sputum specimens can be easily and rapidly known about the drug-resistance gene of M. tuberculosis, but some results can not be interpreted, the reasons to be further explored.