结核分枝杆菌rpoB基因突变与三种利福霉素类抗结核药物耐受相关性研究  

Correlation between mutations in the rpoB gene of Mycobacterium tuberculosis and the resistance of Mycobacterium tuberculosis to three rifamycins

作　　者：刘银萍 王杰 张俊仙 李洪敏 吴雪琼 

机构地区：[1]解放军第三〇九医院全军结核病研究所,全军结核病防治重点实验室,结核病诊疗新技术北京市重点实验室,北京100091

出　　处：《中国病原生物学杂志》2016年第11期982-985,共4页Journal of Pathogen Biology

基　　金：“十一五”国家重大传染病专项(No.2008ZX10003-001);军队医学科技“十二五”重点项目(No.BWS11J050);解放军第三〇九医院课题(No.2014MS-012)

摘　　要：目的研究结核分枝杆菌(Mtb)rpoB基因突变与3种利福霉素类抗结核药物耐受之间的关系,了解Mtb对3种利福霉素类抗结核药物的耐药情况。方法 104例PNB、TCH鉴别培养Mtb阳性患者的临床标本通过绝对浓度法同时进行利福平(RFP)、利福喷丁(RFT)和利福布丁(RFB)药敏试验,并用基因芯片检测Mtb rpoB基因型。结果在104例患者临床标本中,传统药敏试验显示Mtb对RFP、RFT和RFB的耐药率分别为22.1%(其中高耐药率19.2%、低耐药率2.9%)、21.2%(其中高耐药率18.3%、低耐药率2.9%)、20.2%(其中高耐药率11.5%、低耐药率8.7%)。以传统药敏试验为对照,基因芯片检测rpoB基因突变预示RFP、RFT和RFB耐受的灵敏度分别为78.3%(18/23)、77.3%(17/22)和81.0%(17/21),特异性分别为88.9%(72/81)、87.8%(72/82)和88.0%(73/83)。结论 Mtb对3种利福霉素类抗结核药物耐受的一致率高,rpoB基因突变与3种利福霉素类药物耐受密切相关。应用基因芯片可快速检测其耐药基因型,指导临床合理用药。Objectives To study the relationship between mutations in the rpoBgene of Mycobacterium tuberculosis and the resistance of M.tuberculosis to three rifamycins and to ascertain the resistance of M.tuberculosis to rifampicin（RFP）,rifapentine（RFT）,and rifabutin（RFB）. Methods One hundred and four clinical specimens of M.tuberculosis identified by culturing on nitrobenzoic acid（PNB）and thiophene-carboxylic acid hydrazide（TCH）media were tested for susceptibility to RFP,RFT,and RFB at the same time using the absolute concentration method,and mutations in the rpoBgene of M.tuberculosis were detected with a gene chip. Results Conventional drug susceptibility testing of the104 clinical specimens indicated that their resistance to RFP was 22.1%（highest rate of resistance：19.2%;lowest rate of resistance：2.9%）,their resistance to RFT was 21.2%（highest rate of resistance：18.3%;lowest rate of resistance：2.9%）,and their resistance to RFB was 20.2%（highest rate of resistance：11.5%;lowest rate of resistance：8.7%）.Compared to conventional drug susceptibility testing,the gene chip detected mutations in the rpoBgene of M.tuberculosis resulting in resistance to RFP with a sensitivity of 78.3%（18/23）,it detected mutations in the rpoBgene resulting in resistance to RFT with a sensitivity of 77.3%（17/22）,and it detected mutations in the rpoBgene resulting in resistance to RFB with a sensitivity of 81.0%（17/21）.The gene chip detected mutations in the rpoBgene resulting in resistance of M.tuberculosis to RFP with a specificity of 88.9%（72/81）,it detected mutations in the rpoBgene resulting in resistance to RFT with a specificity of 87.8%（72/82）,and it detected mutations in the rpoBgene resulting in resistance to RFB with a specificity of 88.0%（73/83）. Conclusion M.tuberculosis had a highly similar rate of resistance to three rifamycins（RFP,RFT and RFB）.Mutations in the rpoBgene were closely related to resistance to the three rifamycins.A gene chip can rapidly detect dru

关 键 词：结核分枝杆菌 利福霉素类药物 RPOB基因 基因芯片 耐药 

分 类 号：R378.911[医药卫生—病原生物学]