耐多药结核分枝杆菌中embB基因突变与乙胺丁醇耐药的相关性研究  

Association between emb B mutation of multidrug-resistant Mycobacterium tuberculosis and its ethambutol resistance

作　　者：刘志广[1,2] 孙庆[1,2,3] 刘海灿[1,2] 肖彤洋 赵秀芹[1,2] 万康林[1,2] 赵丽丽[1,2] 

机构地区：[1]中国疾病预防控制中心传染病预防控制所/传染病预防控制国家重点实验室,北京102206 [2]感染性疾病诊治协同创新中心,浙江杭州310003 [3]南华大学病原生物研究所,湖南衡阳421001

出　　处：《疾病监测》2015年第4期321-324,共4页Disease Surveillance

基　　金：国家自然科学基金(No.81201348);国家科技重大专项(No.2013ZX10003002-001)~~

摘　　要：目的研究耐多药结核分枝菌中emb B基因突变与乙胺丁醇耐药的相关性。方法比例法检测84株耐多药结核分枝杆菌的乙胺丁醇(EMB)耐药性,基因测序检测emb B基因的突变,χ2检验分析二者之间的相关性。结果84株耐多药结核分枝杆菌中有43株(51.2%)对EMB耐药,41株(48.8%)对EMB敏感,57株耐多药菌株(67.9%)的emb B基因发生突变。在43株EMB耐药菌株中,emb B基因突变的菌株为40株(93.0%),而41株EMB敏感菌株中,emb B基因突变的菌株为17株(41.5%),emb B基因在耐药菌株中的突变频率远高于敏感菌株(χ2=25.58,P=0.00)。emb B306是最常见的突变位点,其在耐药菌株的突变率也高于敏感菌株(χ2=12.37,P=0.00),emb B基因和emb B306位点检测EMB耐药的敏感度、特异度和准确性分别为93.0%和65.1%,58.5%和73.2%,76.2%和69.0%。结论 EMB耐药的产生与emb B基因和emb B306突变有关,二者用于检测EMB耐药有一定的参考意义。Objective To investigate the association between embB mutation of multidrug-resistant Mycobacterium tuberculosis （MDR-TB） and its ethambutol （EMB） resistance. Methods Proportion method was used to detect the EMB resistance of 84 strains of MDR-TB and gene sequencing was conducted to detect the mutation of embB gene. The association between embB mutation and the ethambutol resistance was also analyzed with chi-square test. Results Among the 84 strains of MDR-TB, 43 were resistant to EMB （51.2%）, 41 were sensitive to EMB （48.8%）. embB mutation occurred in 57 MDR-TB strains（67. 9% ） and in 40 out of 43 EMB resistant strains（90. 3% ）. Among the 41 EMB sensitive strains, embB mutation was detected in 17 strains（41.5% ）. The mutation rate of embB was much higher in EMB resistant strains than in EMB sensitive strains, embB306 was the major mutation loci, and the mutation occurred at this loci in EMB resistant strains was much higher in EMB sensitive strains. （χ2 = 12. 37, P = 0.00）. The sensitivity, specificity and accuracy of EMB susceptibility test in embB and at embB306 were 93.0% and 65.1%, 58.5% and 73.2%, and 76. 2% and 69.0% respectively. Conclusion EMB resistance was associated with embB and mutation at embB306.

关 键 词：耐多药结核分枝杆菌 乙胺丁醇 耐药 突变 

分 类 号：R378.911[医药卫生—病原生物学]