结核分枝杆菌耐药基因检测

Drug-resistant gene detection in clinically isolated Mycobacterium tuberculosis isolates

  • 摘要: 目的:研究结核分枝杆菌(Mycobacterium tuberculosis,MT)耐药的分子机制,建立快速检测耐药基因型的分子药敏试验方法。方法:通过聚合酶链反应(Polymerase chain reaction,PCR)、PCR-单链构象多态性(Single-stranded conformation polymorphism,SSCP)、PCR-限制性片段长度多态性(Restriction fragment lengthpoly-morphism,RFLP)分析MT临床分离株的rpoB、rpsL、KatG基因和inhA调节序列。结果:PCR分析耐药基因的敏感性为1~10pgDNA;除rpoB引物PCR扩增为属特异性外,余耐药基因引物PCR扩增都具有较高的种特异性。与传统药敏试验方法相比,PCR和PCR-SSCP检测62株MT分离株利福平(Rifampin,RFP)、链霉素(Streptomycin,SM)和异烟肼(Isoniazid,INH)耐药基因型的灵敏度和特异度分别为93.8%和96.2%(rpoB)、81.6%和91.7%(rpsL)、76.0%和75.7%(katG)、16%和100%(inhA)。20株耐多药分离株,90%2种以上耐药基因突变。通过PCR-RFLP分析MT的rpsL,该基因所有突变均位于43位氨基酸密码子。结论:rpoB、rpsL和katG基因改变分别是MT耐RFP、SM和INH的重要分子机制,通过PCR、PCR-SSCP和PCR-RFLP等分子生物学检测手段可简便、快速地检测大部分MT的耐药基因型。

     

    Abstract: Objective:To research the molecular mechanisms of drug resistance in M. tuberculosis, and to develop a new method for detecting the drug resistance. Methods:The rpoB, rpsL, katG genes and inhA regulatory sequence in 62 M. tuberculosis clinical isolates were analysed with PCR, PCR-SSCP and PCR-RFLP. Results:The sensitivity of amplifying the drug-resistant genes with PCR was 1 ̄10 pg DNA. In comparison with conventional susceptibility testing methods, the sensitivity and specificity of detecting the drug-resistant genes in M. tuberculosis isolates with PCR and PCR-SSCP were 93.8% and 96.2% for rpoB, 81.6% and 91.7% for rpsL, 76.0% and 75.7% for katG, and 16% and 100% for inhA, respectively. 90% of the multidrug-resistant strains had mutations in more than two drug-resistant genes. We had analyzed the rpsL gene codon 43 in streptomycin-resistant isolates. It was found that the rpsL gene mutations all situated at codon 43.Conclusion:Alterations in rpoB, rpsL and katG gene may be the important mechanisms of M. tuberculosis resistance to rifampin, streptomycin and isoniazid. PCR, PCR-SSCP and PCR-RFLP are going to become the simple, rapid and reliable diagnostic tests for drug resistance.

     

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