四川德阳地区结核分枝杆菌耐药基因突变位点的分布特点及基因型耐药的分析  

Distribution Characteristics and Analysis of Genotype Drug Resistance of Drug-resistant Gene Mutations in Mycobacterium Tuberculosis in Deyang District, Sichuan

作　　者：杨家红[1] 张浩[1] 王秀[1] 陈皋[1] 陈学兵[1] 罗万蓉[1] 蒋舒明[1] 

机构地区：[1]德阳市人民医院感染科,四川德阳618000

出　　处：《华西医学》2014年第8期1487-1490,共4页West China Medical Journal

摘　　要：目的探讨四川德阳地区结核分枝杆菌耐药基因突变位点的分布特点及基因型耐药的分析。方法收集在2010年2月-2013年3月检出的257例肺结核病患者结核分枝杆菌DNA阳性的痰液标本,采用聚合酶链式反应(PCR)和反向点杂交(RDB)相结合的基因芯片技术对结核分枝杆菌耐药基因突变位点进行检测和分析。结果 257例肺结核患者中检测出49例存在结核分枝杆菌耐药基因位点突变,其中发生katG 315、rpsL43、embB 306和rpoB 531丝氨酸(S531L)位点突变的分别为30例(11.67%)、18例(7.00%)、11例(4.28%)和10例(3.89%)。234例初治肺结核患者对异烟肼、利福平、乙胺丁醇及链霉素的基因型耐药率分别为9.83%、4.27%、3.42%和5.13%,耐多药率为2.99%;23例复治肺结核患者对上述药物的基因型耐药率分别为52.17%、26.09%、13.04%和43.48%,耐多药率为13.04%。初治患者的基因型耐药率及耐多药率均明显低于复治患者。结论四川德阳地区结核分枝杆菌常见耐药基因突变位点分别为katG 315、rpsL 43、embB 306和rpoB 531丝氨酸(S531L)突变位点;肺结核初治患者的基因型耐药率及耐多药率均明显低于复治患者;该地区肺结核的耐多药率相对较低。Objective To explore distribution characteristics of drug-resistant mutations and analyze drugresistant genotypes in Mycobacterium tuberculosis in Deyang district, Sichuan. Methods A total of 257 patients infected with Mycobacterium tuberculosis and positive for mycobacterium tuberculosis DNA who were detected from February 2010 to March 2013 were included in our research. Drug-resistance mutations were detected and analyzed using gene chip technology combining by polymerase chain reaction（PCR） and reverse dot hybridization（RDB）. Results In these 257 pulmonary tuberculosis patients, drug-resistance mutations were detected in 49 with pulmonary tuberculosis. Drugresistance mutation rate at katG 315, rpsL 43, embB 306 and rpoB 531（S531L） was 11.67%（30/257）, 7.00%（18/257）, 4.28%（11/257） and 3.89%（10/257）, respectively. In 234 initially treated pulmonary tuberculosis patients, the rate of isoniazidresistant genotype, rifampicin-resistant genotype, ethambutol-resistant genotype, streptomycin-resistant genotype and multidrug resistant genotype was 9.83%, 4.27%, 3.42%, 5.13% and 2.99%, respectively. In 23 retreated pulmonary tuberculosis patients, these rates was 52.17%, 26.09%, 13.04%, 43.48% and 13.04%, respectively. Conclusions In Deyang district, Sichuan, drug-resistant genotypes for isoniazid, rifampicin, ethambutol and streptomycin are detected in Mycobacterium tuberculosis. Most of the drug-resistant mutations occur at katG 315, rpsL 43, embB 306 and rpoB 531. The rates of drugresistant genotypes and multi-drug resistance in initially treated pulmonary tuberculosis patients are lower than those in retreated patients. Multi-drug resistant rate is relatively low in our research.

关 键 词：结核分枝杆菌 耐药基因 突变 

分 类 号：R378.911[医药卫生—病原生物学]