结核分枝杆菌利福平耐药突变基因检测与BD960药敏的对比
Comparative Analysis of Rifampicin-resistant Mutant Gene Detection of Mycobacterium Tuberculosis and Drug Sensitivity BD960
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摘要: 目的 分析对比结核分枝杆菌利福平PCR-反向点杂交法耐药基因突变位点检测和BACTEC MGIT960 System表型药敏结果的相关性。方法 同时对220例住院患者的痰或肺泡灌洗液 (BALF) 用PCR-反向点杂交法检测利福平耐药基因突变位点与BACTEC MGIT 960 System检测利福平表型药敏结果进行对比分析。结果 2种方法检测利福平药敏结果符合205例, 特异度93% (205/220) ;2种方法检测利福平都敏感的有172例;基因耐药, 表型耐药的有33例, 其中有3例检出rpo B基因H526位点突变, 突变率9%;基因耐药, 表型敏感的有15例, 其中有11例均检出rpo B基因H526位点突变, 突变率73%。结论 PCR-反向点杂交法检测具有快速高效、特异度高等特点, 对临床诊断、治疗有指导意义。Abstract: Objective To analyze and compare rifampicin-resistant gene mutation detection and BACTEC MGIT 960 system phenotype susceptibility test in Mycobacterium tuberculosis by PCR-reverse dot blot hybridization.Methods At the same time, the phenotypic susceptibility of rifampicin to rifampicin was detected by PCR-reverse dot blot hybridization in sputum or bronchoalveolar lavage fluid (BALF) from 220 inpatients and by BACTEC MGIT 960 System. Results The susceptibility of rifampicin to rifampicin by the two methods accorded with 205 cases and the specificity was 93% (205/220) ; both methods were sensitive to rifampicin in 172 cases; gene resistance and phenotypic resistance in 33 cases, of which 3 cases detected mutation at the H526 locus of rpo B gene, with a mutation rate of 9%; gene resistance and phenotypic sensitivity in 15 cases, 11 of which were all detected. The mutation of the H526 locus of rpo B gene was 73%.Conclusions PCR-reverse dot hybridization has the characteristics of high speed, high efficiency and specificity. It has guiding significance for clinical diagnosis and treatment.
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Key words:
- M.tuberculosis /
- Rifampicin /
- Gene analysis on drug-resistant tuberculosis
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[1] [1]World Health Organization.Global tuberculosis report 2016[M].Gnenva:WHO Press, 2016:1-5. [2] [2]HSIAO C H, LIN Y T, LAI C C, et al.Identification of nonyuberculous mycobacterial infection by IS6110 and hsp65 gene analysis on lung tissues[J].Diagn Microbiol Infect Dis, 2010, 68 (3) :241-246. [3] [3]WARNER D F, MIZRAHI V. Complex genetics of drug resistance in Mycobacterium tuberculosis[J].Nat Genet, 2013, 45 (10) :1107-1108. [4] [4]AHMAD S, MOKADDAS E. Recent advances in the diagnoisis and treatment of multidrug-resistant tuberculosis[J].Respir Med, 2009, 103 (12) :1777-1790. [5] [5] MUNKHDELGER J, WANG HY, CHOI Y, et al. Idengtifacation of Mycobacterium species in FFPE granulomatous lymphadenitis tissue using REBA Myco-ID[J].Int J Tuberc Lung Dis, 2013, 17 (7) 898-902. [6] [6]Companion handbook to the WHO guidelines of the programmatic management of drug-resistant tuberculosis[M].Geneva:WHO Press, 2014:46-47. [7] 车南颖, 张海青.中华医学会结核病学分会结核病病理学专家共识编写组, 中国结核病病理学诊断专家共识[C].中华医学会结核病学分会2017年学术汇编.厦门:中华医学会结核病学分会, 2017:10. [8] [8]SIMONS S O, VAN DER LAAN T, DE TWAAN R, et al.Molecular drug susceptibility testing in the Netherlands:performance of the MTBDRplus and MTBDSsl assays[J].Int J Tuberc Lung Dis, 2015, 19 (7) :828-833. [9]张卓然, 夏梦岩, 倪语星.微生物耐药的基础与临床[M].北京:人民卫生出版社, 2007:194. [10] [10]MUNKHDEGLGER J, WANG HY, CHOI Y, et al. Identification of Mycobacterium species in FFPE granulomatous lymphadenitis tissue using REBA Myco-ID[J].Int J Tuberc Lung Dis, 2013, 17 (7) :888-900. [11]谭景尹, 韦世录, 李翠萍, 等.PCR-膜芯片检测石蜡包埋组织中结核杆菌耐药基因突变[J].临床与实验病理学杂志, 2012, 28 (8) :895-899. [12]甘辛, 陈玲, 王建华, 等.结核分枝杆菌耐利福平rpo B基因突变的序列分析[J].基础医学与临床, 2010, 30 (3) :268-271. [13]赵玉玲, 杨洪毅, 马晓光, 等.河南省耐多药结核分枝杆菌利福平耐药基因rpo B的突变特征[J].郑州大学学报 (医学版) , 2012, 47 (2) :166-169. [14]欧维正, 骆科文, 王燕, 等.基因芯片和比例法药物敏感性试验检测结核分枝杆菌对利福平和异烟肼耐药性的比较研究[J].检验医学, 2013, 28 (5) :404-407. -

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