利用GenoType■MTBDRplus技术分析福州市结核耐药基因突变特征  

Analysis of mutation characteristics of Mycobacterium tuberculosis resistance genes in Fuzhou with GenoType■MTBDRplus technology

作　　者：叶海梅[1] 刘杰 吴祖达[1] 林建[2] 张宝华 陈坤 潘洁茹[1] YE Hai-mei;LIU-Jie;WU Zu-da;LIN Jian;ZHANG Bao-hua;CHEN Kun;PAN Jie-ru(Fuzhou Center for Disease Control and Prevention,Fuzhou,Fujian 350004;Fujian Provincial Center for Disease Control and Prerention,Fuzhou,Fujian 350001;The Second Department of Clinical Liboratory of 900 Hospital of the Joint htgistics Team,Fuzhou,Fujian 350003,China)

机构地区：[1]福州市疾病预防控制中心,福建福州350004 [2]福建省疾病预防控制中心,福建福州350001 [3]联勤保障部队第九〇〇医院二部检验科,福建福州350003

出　　处：《热带医学杂志》2021年第1期22-25,共4页Journal of Tropical Medicine

基　　金：福州市科技计划项目(2012-S-161)。

摘　　要：目的了解福州市结核菌的耐药基因突变特征,分析突变位点和突变频率,为本地区耐多药结核病诊疗提供更多的数据。方法利用GenoType■MTBDRplus技术对福州市近年分离的352株结核分枝杆菌进行检测,分析其rpoB、katG和inhA基因的突变特征。结果福州市352株结核菌株,总耐药率13.92%(49/352),ropB耐药基因突变率7.67%(27/352),异烟肼耐药基因突变率13.92%(49/352),耐多药结核菌(MDR-TB)发生率7.67%(27/352)。利福平耐药基因rpoB突变以S531L位点突变最常见,占55.56%(15/27)。异烟肼耐药katG基因突变占75.51%(37/49),inhA突变占24.49%(12/49)。katG突变以S315T1最常见,占59.18%(29/49);inhA基因突变以inhA C15T最常见,占22.45%(11/49)。MDR-TB以rpoB S531L-katG S315T1突变类型最常见,占40.74%(11/27)。结论福州地区结核分枝杆菌对利福平、异烟肼和MDR-TB耐药率总体水平均低于全国平均水平,耐利福平、耐异烟肼菌株和MDR-TB的基因突变存在主流突变类型,分别为rpoB S531L、katG S315T1和inhA C15T、rpoB S531L-katG S315T1,对今后福州市耐多药结核病的快速诊断和控制提供了理论依据。Objective To understand the mutation characteristics of drug-resistant genes of tuberculosis bacteria in Fuzhou,the mutation sites and mutation frequencies were analyzed,which provide more data for the diagnosis and treatment ofmultiple drug-resistant tuberculosis(MDR-TB)in Fuzhou.MethodThe Geno Type■MTBDRplus technology was used todetect 352 strains of Mycobacterium tuberculosis isolated in Fuzhou in recent years,and the mutation characteristics of theirrpo B,kat G and inh A genes were analyzed.Results The total molecular resistance rate of the 352 tuberculosis strains inFuzhou was 13.92%(49/352),whereas the mutation rates of rop B resistance gene,isoniazid resistance gene,MDR-TBwere 7.67%(27/352),13.92%(49/352)and 7.67%(27/352),respectively.The mutation site of the rifampicin resistancegene rpo B was mostly found in the S531 L(55.56%,15/27).kat G and inh A mutations were accounted for 75.51%(37/49)and 24.49%(12/49),respectively in the isotrazine-resistant strains.The most common kat G mutation was S315 T1(59.18%,29/49),whereas 22.45%(11/49)of the mutation in the inh A gene was C15 T.The combined mutation in theS531 L of rpo B and the S315 T1 of kat G was the main mutation type of MDR-TB(40.74%,11/27).Conclusion s Theoverall levels of molecular resistance to rifampicin and isoniazid of M.tuberculosis and MDR-TB in Fuzhou area were lowerthan the national average level.The S531 L of rpo B,the S315 T1 of kat G,the C15 T of inh A,and the S531 L of rpo B-S315 T1 of kat G were mainstream types of gene mutation in the strains resistant to rifampicin,isoniazid,and MDR-TB,whichprovide theoretical basis for the rapid diagnosis and control of MDR-TB in Fuzhou in the future.

关 键 词：结核分枝杆菌 GenoType■MTBDRplus技术 耐多药结核菌 基因突变 

分 类 号：R378.911[医药卫生—病原生物学]