耐多药结核分支杆菌基因突变在耐药性检测中应用.doc

耐多药结核分支杆菌基因突变在耐药性检测中应用 　【摘要】 目的 探讨耐多药结核病（MDR-TB）临床分离株rPOB、KatG和rpsL基因突变在耐药性检测中的应用价值。方法 采用聚合酶链反应-单链构象多态性（PCR-SSCP）技术分析了54株同时耐异烟肼（INH）、利福平（RFP）、链霉素（SM）的多耐药临床分离株和45株药物敏感株的rPOB、KatG、rpsL基因突变。结果 以结核分支杆菌H37RV为对照，45株药物敏感株的rPOB、rpsL基因SSCP图谱正常，其特异性为100%；KatG基因有2株图谱异常，特异性为95.6%。89株结核分支杆菌临床分离株均未发现rPOB、KatG、rpsL基因缺失，其PCR扩增产物SSCP分析结果表明：54株多耐药临床分离株中，49株rPOB基因图谱异常；32株KatG基因图谱异常；40株rpsL基因图谱异常。其敏感性分别为rPOB(90.7%)、KatG(59.3%)，rpsL(74.1%)。结论 结核分支杆菌耐RFP、INH、SM耐药性的产生主要是由于rPOB、KatG和rpsL基因突变所致。PCR-SSCP技术有望成为结核分支杆菌耐药性检测的方法之一。 【关键词】 结核分支杆菌；rPOB基因；KatG基因；rpsL基因；SSCP；药物耐受性 Studies of Mycobacterium tuberculosis multi-drug resistant gene 【Abstract】 Objective To evaluat the importance of rPOB、KatG and rpsL gene mutation detection in multi-drug resistant clinical isolates of Mycobacterium tuberculosis. Methods rPOB、KatG and rpsL gene mutation of 54multi-drug resistant clinical isolates，which is INH RFP and Sm resistance and 54 drug susceptible strains were analyzed using polymerase chain reaction-single strand conformation (PCR-SSCP).Results SSCP pattern of H37RV strain as control，SSCP pattern of rPOB，rpsL PCR amplification from drug susceptible strains were all the same as control. The specificity was 100%. However，the different SSCP pattern of KatG gene were found in 2 susceptible strains. The specificity was 96.3%. Gene deletion of rPOB、KatG and rpsL were not found in all clinical isolates tested. SSCP patterns of rPOB gene were different from control in 49 drug resistant clinical isolates. SSCP patterns of KatG gene were different from control in 32drug resistant clinical isolates，SSCP pattern of rpsL gene were different from control in 40 drug resistant clinical isolates. The sensitivity were 90.1% (rPOB)，59.3% (KatG) and rpsl (74.1%)，respectively. Conclusion The major mechanism of RFP，INH，SM resistant drug was rPOB、KatG and rpsL gene mutation，respectively PCR-SSCP may be one of the way which applied to drug resistant detection of Mycobacterium tuberculosis. 【Key words】 Mycobacterium tuber