江西1010例PCR-线性杂交酶显色法检测结核分枝杆菌耐药性结果分析  

Drug resistance of Mycobacterium tuberculosis detected by PCR linear hybridization in 1010 cases of Jiangxi

作　　者：赵竟男[1] 江友桥 伍文华[1] 黄锐[1] 肖岗[1] ZHAO Jing-nan;JIANG You-qiao;WU Wen-hua;HUANG Rui;XIAO Gang(Jiangxi provincial Center for Disease Prevention and Control,Nanchang,Jiangxi 330029,China)

机构地区：[1]江西省疾病预防控制中心结防所,江西南昌330029

出　　处：《现代预防医学》2021年第23期4356-4360,共5页Modern Preventive Medicine

基　　金：江西省卫生计生委科技计划(20156010,20204833)。

摘　　要：目的评价PCR-线性杂交酶显色法在江西的应用效能,分析江西地区结核分枝杆菌相关耐药基因rpoB、katG、inhA的变异特征。方法采集江西省肺结核涂阳患者痰标本或经离培养获得的分离株共1 010例,采用PCR-线性杂交酶显色法检测rpoB、katG、inhA基因突变情况,同时对其中860例进行了罗氏药敏检测。结果以罗氏药敏为"金标准"评价PCR-线性杂交酶显色法检测利福平耐药性的敏感度和特异度分别为88.69%和96.24%;检测异烟肼耐药性的敏感度和特异度分别为77.29%和96.39%。在304株利福平耐药rpoB突变株中,突变频率高的位点是531位点、526位点次之;309株katG和inhA基因突变株中,katG S315T1占73.14%、inhA C15T占12.62%。异质性耐药突变菌株占3.61%。结论 PCR-线性杂交酶显色法是耐药结核病快速筛查的有效方法,江西利福平、异烟肼耐药株主要基因突变型为rpoB的S531L和katG的S315T1,高水平耐药菌株所占比例大。Objective To evaluate the application efficiency of PCR linear hybridization enzyme chromogenic assay in Jiangxi Province and analyze the variation characteristics of rpoB, katG and inhA genes related to drug resistance of Mycobacterium tuberculosis in Jiangxi Province. Method A total of 1 010 cases of sputum specimens or isolates from smear positive pulmonary tuberculosis patients in JiangXi province were collected. MTBDRplus was used to detect mutations of rpoB, katG and inhA genes, among which 860 cases were tested for traditional drug sensitivity. Result The common mutations of rpoB, katG and inhA in 860 Mycobacterium strains were detected by linear probe method. The sensitivity and specificity of rifampicin and isoniazid resistance by MTBDRplus were evaluated with traditional drug sensitivity. The sensitivity and specificity of rifampicin resistance were 88.69%% and 96.24% and isoniazid resistance were 77.29% and 96.39%, respectively. In rifampin resistant rpoB mutant strains, the highest mutation frequency sites were 531, 526. Among the isoniazid resistant mutants, the sites with the highest mutation frequency were S315 T1(73.14%) of katG and C15 T(12.62%) of inhA. Heterogenous drug-resistant mutant strains accounted for 3.61%. Conclusion PCR linear hybridization enzyme chromogenic assay is an effective method for rapid drug resistance screening of tuberculosis. The main gene mutants of rifampicin and isoniazid resistant strains in Jiangxi province are S531 L of rpoB and S315 T1 of katG, high level of drug-resistant strains account for a large proportion.

关 键 词：结核分枝杆菌 耐药 突变 

分 类 号：R115[医药卫生—公共卫生与预防医学]