乙胺丁醇耐药表型与耐药基因embB突变的关系  

Relationship between EMB phenotypic drug resistance and embB mutation

作　　者：张楠[1] 胡继红[1] 万康林[2] 

机构地区：[1]卫生部北京医院卫生部临床检验中心,北京100730 [2]传染病预防控制国家重点实验室中国疾病预防控制中心传染病所,北京102206

出　　处：《中国卫生检验杂志》2010年第3期490-492,571,共4页Chinese Journal of Health Laboratory Technology

基　　金：国家自然科学基金(30771853)

摘　　要：目的:探讨乙胺丁醇(Ethambutol,EMB)耐药基因embB点突变与耐药表型间的关系,分析点突变与耐多药、耐药种类数的关系以及Met306突变检出耐多药结核。方法:对来自7省市的301株结核分枝杆菌临床分离株进行比例法药敏试验,并对embB、katG、rpoB耐药决定区进行扩增测序检测基因突变位点。结果:Met306突变率在EMB耐药株(48.5%)与EMB敏感株(39.1%)间差异无统计学意义,而在耐多药组(47.1%)与非耐多药组(9.4%)间差异有统计学意义,且随耐药种类数增加突变率增加。对耐多药株,rpoB突变与耐多药表型符合率为80%,增加Met306突变检测后与表型符合率提高至93.3%,katGSer315突变与耐多药表型符合率为80%,增加Met306突变检测后符合率提高至86.7%,而三个耐药基因联合能检测出97.8%的耐多药株。结论:embBMet306突变作为EMB耐药的分子标志值得商榷,但其突变能作为耐多药结核检测的分子标志,与公认的耐多药株分子标志-rpoB联合能提高耐多药株的检出率。Objective：To analyze the relationship between genotype resistance and phenotype resistance of Ethambutol（EMB）,the correlation between mutation and multi-drug resistant tuberculosis（MDR-TB） and to make use of Met306 mutation to detect MDR-TB.Methods：Totally 301 isolates collected in China were tested by drug sensitive test（DST） and sequencing in the drug resistant determined region（DRDR） of embB,katG and rpoB.Results：The mutation rate between the EMB-resistance（48.5%） and EMB-susceptibility（39.1%） was no significance（P0.05）,however it was found statistics difference（P0.05） not only to MDR-TB but also the numbers of drugs.Moreover for MDR-TB,the coincidence rate between Met306 combined rpoB mutation and phenotypic resistance increased from 80% to 93.3%,meanwhile the rate between Met306 combined katG mutation and phenotypic resistance increased from 80% to 86.7%.Met306 combined rpoB and katG could detect 97.8% MDR-TB.Conclusion：Mutations in Met306 could not be the EMB molecular marker.As a new MDR-TB marker,combined rpoB-the acknowledged MDR molecular marker,it would largely improve the checkout rate of MDR.

关 键 词：结核分枝杆菌 乙胺丁醇 表型耐药 基因型耐药 耐多药结核 耐药基因 突变株 分子标志 突变率 基因突变 

分 类 号：R378.911[医药卫生—病原生物学]