耐药结核分枝杆菌与耐药基因突变的相关性分析

Correlation analysis between drug-resistant Mycobacterium tuberculosis and drug-resistant gene mutation

探讨结核患者结核分枝杆菌(MTB)耐药性与基因突变情况。68例临床分离菌株采用罗氏药敏实验检测MTB对利福平(RFP)、异烟肼(INH)、链霉素(SM)、吡嗪酰胺(PZA)和乙胺丁醇(EMB)的耐药情况,采用聚合酶链反应-单链构象多态性分析(PCR-SSCP)检测MTB临床分离株耐利福平(rpo B)、异烟肼(kat G)、链霉素(rps L)、吡嗪酰胺(pnc A)、乙胺丁醇(emb B)基因突变率,5种耐药基因突变率依次为78. 2%、69. 8%、72. 2%、43. 8%、31. 4%,其中高耐株基因突变率分别为92. 1%、80. 0%、87. 5%、72. 0%、45. 5%。低耐株分别为47. 1%、25. 0%、28. 5%、13. 0%、7. 7%。MTB耐药基因突变与耐药水平密切相关,PCR-SSCP法检测结核分枝杆菌rpo B、kat G、rps L、pnc A和emb B基因突变快速、敏感、特异。

To understand the drug resistance and gene mutation of Mycobacterium tuberculosis( MTB) in patients with pulmonary tuberculosis. The resistance of Mycobacterium tuberculosis to Rifampin( RFP),isoniazid( INH),streptomycin( SM),pyrazinamide( PZA) and ethambutol( EMB) was detected by Roche susceptibility test in 68 clinical isolates. The polymerase chain reaction single strand conformation multistate analysis( PCR-SSCP) was used to detect tuberculosis branching. Bacterial rpoB,katG,rps L,pncA and embB gene mutations. The mutation rates of rifampin resistant( rpoB),isoniazid( katG),streptomycin( rps L),azinamine( pncA) and ethambutol( embB) were 78. 2%,69. 8%,72. 2%,43. 8% and 31. 4%,respectively. The mutation rates of high resistant strains were 92. 1%,80. 0%,87. 5%,72. 0% and 45. 5%,respectively. The low resistant plants were 47. 1%,25. 0%,28. 5%,13. 0% and 7. 7%,respectively. The mutation of drug-resistant gene of Mycobacterium tuberculosis is closely related to the level of drug resistance. The PCR-SSCP method is rapid,sensitive and specific for detecting rpoB,katG,rpsL,pncA and embB mutations in Mycobacterium tuberculosis.