结核分枝杆菌耐药机制与检测技术研究进展

Research Progress on Resistance Mechanisms and Detecting Technology of Mycobacterium tuberculosis

近年来耐药结核分枝杆菌的不断出现给结核病的治疗带来前所未有的压力。研究发现,不但牛型分枝杆菌可感染人,人型结核分枝杆菌也可感染牛,这也给养牛业的发展带来了威胁与挑战。如何建立快速、简便、敏感性强、特异性好、价格低廉的耐药性检测方法是控制该病蔓延的关键。作者阐述了常用药物异烟肼、利福平、链霉素、乙胺丁醇、吡嗪酰胺等的作用机制及传统分枝杆菌耐药性检测方法(荧光素酶系统、显微镜观察药敏检测技术(MODS)、比例法、Bactec MGIT 960系统)和以分子生物学为基础的分枝杆菌耐药性检测方法(单链探针反向杂交试验(LiPA)、Gene Xpert全自动检测系统、PCR-单链构象多态性分析(PCR-SSCP)、PCR-限制性片段长度多态性分析(PCR-RFLP)、DNA测序、基因芯片技术)的研究进展,以期为进一步的研究与应用提供参考。

In recent years, the constantly emerging of drug resistant Mycobacterium tuberculosis brings unprecedented pressures to treat tuberculosis. In recent studies, it has found that not only bovine-type Mycobacterium tuberculosis can infect people, but human-type Mycobacterium tuber- culosis can also infect cattle, which is also brings threats and challenges to the development of the cattle industry. And how to establish quick, handy, sensitive, highly specific and inexpensive re- sistance testing methods is the key to control the spread of the disease. In this review, it intro- duced not only the mechanism of action of isoniazid, rifampicin, streptomycin, ethambutol, pyrazinamide and so on, but also the traditional detection methods of drug resistance of mycobac- teria （luciferase system, microscopic observation of drug susceptibility, proportion method, Bactec MGIT 960 System）and molecular detection methods （reverse hybriditation-based line probe assay （LiPA）, Gene Xpert automatic detection system, PCR-single-strand conformation polymorphism analysis （PCR-SSCP）, PCR-restriction fragment length polymorphism （ PCR- RFLP）, DNA sequencing, gene chip, RNA/RNA mismatch assay, which may be helpful to the further and clinical treatment and research for tuberculosis.