巨细胞病毒UL97基因突变类型的分析

Analysis on mutation types of cytomegalovirus UL97 gene

目的通过基因测序分析巨细胞病毒(CMV)的UL97基因突变情况,指导临床用药。方法回顾性分析2018年6-12月进行CMV检测的患者情况,分析CMV阳性率在不同标本的分布,并选取CMV拷贝数>1 000copy/mL的标本30例,进行UL97基因片段PCR扩增,对扩增产物进行测序,与CMV标准毒株AD169序列比对,参照国内外报道的耐药相关的热点突变,判定耐药基因突变类型。结果痰标本CMV阳性率检出率最高,达43.57%(210/482),器官移植后患者CMV阳性率最高,为25.00%(22/88);序列分析发现8例移植患者标本发生了UL97基因氨基酸的替代,其中有5例为3个月持续在其血中发现高载量的CMV。结论CMV感染患者UL97基因的检测有助于发现耐药突变,从而有效指导临床用药。

Objective To analyze cytomegalovirus(CMV)UL97 gene mutation situation by the gene sequencing for guiding clinical medication.Methods The CMV detection situation from June to December 2018 was retrospectively analyzed.The distribution of human CMV(HCMV)positive rates in different samples was analyzed.Thirty samples of CMV copy number>1 000 copy/mL were selected.The UL97 gene segment conducted the PCR amplification,The amplification products were sequenced and compared with AD169 sequence in CMV standard toxic strain AD169.Then the mutation type of drug resistant gene was judged by referring to drug resistance related hotpoint mutation reported by domestic and abroad.Results The detection rate of CMV positive rate was the highest in sputum samples,reaching 43.57%(210/482),and the CMV positive rate was the highest in organ transplantation patients,reaching 25.00%(22/88).The sequence analysis revealed that amino acid substitution of the UL97 gene occurred in 8 transplant patients,among them,5 cases of high load CMV were found in blood for persistent 3 months.Conclusion The UL97 gene detection in the patients with CMV infection can help to find drug-resistant mutations,thus effectively guide clinical medication.