南宁市某医院2014-2017年结核分枝杆菌rpoB、katG和inhA突变监测分析
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摘要
目的了解某院结核分枝杆菌rpoB、katG和inhA突变特征及耐药性。方法采集经聚合酶链反应(PCR)鉴定为结核分枝杆菌的标本2 624份,采用线性探针(LipA)法检测rpoB、katG和inhA突变。结果 2 072份结果有效,rpoB、katG及inhA突变率依次是14.77%、12.11%及2.80%;相关利福平、异烟肼耐药率及耐多药率为14.77%、14.62%、9.60%。异烟肼耐药株中katG 315位突变占82.84%,rpoB突变株中突变频率居前的位点是531(63.40%)、H526Y或H526D(11.11%)、其他H526(8.50%),突变类型中"突变型探针出现并对应野生型探针缺失"占81.37%。结论该院结核分枝杆菌rpoB、katG和inhA突变特征与国内文献报道相近,相关利福平、异烟肼耐药率及耐多药率高于广西平均水平。
Objective To understand the mutation characteristics of Mycobacterium tuberculosis rpoB,katG and inhA genes and drug resistance in our hospital.Methods A total of 2 624 samples identified by PCR as Mycobacterium tuberculosis were collected.The mutation in rpoB,katG,and inhA genes were determined by Liner probe Assay(LipA).Results The results of 2 072 cases were valid.The mutation rate of rpoB,katG,and inhA was 14.77%,12.11%,and 2.80%,respectively.The drug resistance rate of rifampicin,isoniazid and multi-drug resistance rate was 14.77%,14.62%,and 9.60%,respectively.Among the isoniazid-resistant mutants,the katG 315 mutation accounted for 82.84%.And among the rpoB mutants the top three mutation sites were 531(63.40%)、H526 Yor H526 D(11.11%),and other H526(8.50%)location.In the mutation type, " mutant probes appearing and corresponding wild type missing" accounted for 81.37%.Conclusion The mutation characteristics of rpoB,katG,and inhA genes in Mycobacterium tuberculosis identified in this hospital are similar to those reported in the domestic literature.The related drug resistance rates of rifampicin,isoniazid and multi-drug are higher than the average rate in Guangxi region.
Objective To understand the mutation characteristics of Mycobacterium tuberculosis rpoB,katG and inhA genes and drug resistance in our hospital.Methods A total of 2 624 samples identified by PCR as Mycobacterium tuberculosis were collected.The mutation in rpoB,katG,and inhA genes were determined by Liner probe Assay(LipA).Results The results of 2 072 cases were valid.The mutation rate of rpoB,katG,and inhA was 14.77%,12.11%,and 2.80%,respectively.The drug resistance rate of rifampicin,isoniazid and multi-drug resistance rate was 14.77%,14.62%,and 9.60%,respectively.Among the isoniazid-resistant mutants,the katG 315 mutation accounted for 82.84%.And among the rpoB mutants the top three mutation sites were 531(63.40%)、H526 Yor H526 D(11.11%),and other H526(8.50%)location.In the mutation type, " mutant probes appearing and corresponding wild type missing" accounted for 81.37%.Conclusion The mutation characteristics of rpoB,katG,and inhA genes in Mycobacterium tuberculosis identified in this hospital are similar to those reported in the domestic literature.The related drug resistance rates of rifampicin,isoniazid and multi-drug are higher than the average rate in Guangxi region.
引文
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[2]武洁,唐利红,杨崇广,等.全基因组测序技术在结核病流行病学调查中的应用[J].中华流行病学杂志,2016,37(12):1644-1646.
[3]World Health Organization.Implementing tuberculosis diagnostics.Policy framework[M].Geneva:World Health Organization,2015:1-39.
[4]李永文,李新旭,邓云峰,等.中国开展GenoType MTB-DRplus检测结核分枝杆菌对异烟肼和利福平耐药性的Meta分析[J].中华传染病杂志,2016,34(8):494-500.
[5]赵雁林.结核病实验室标准化操作与网络建设[M].北京:人民卫生出版社,2013:69-265.
[6]邓叶华.湖南省结核病耐药情况分析及耐药突变位点分布[D].衡阳:南华大学,2016.
[7]多丽娜,王婷婷,宋兴勃,等.分子线性探针技术分析四川地区结核分枝杆菌耐药情况[J].南方医科大学学报,2011,31(5):822-824.
[8]马利,茹浩浩,陈连,等.线性探针法检测云南地区结核分枝杆菌耐药的应用评价[J].临床检验志,2015,33(8):573-576.
[9]程曦,李亚斐,饶英,等.2 217例结核病患者耐药情况的流行病学特征分析[J].重庆医学,2015,44(2):1635-1637.
[10]徐凯进,嵇仲,康胡海,等.浙江省12个区(县)分枝杆菌菌种鉴定及耐药相关基因特征分析[J].中国防痨杂志,2017,39(2):154-157.
[11]蓝如束,蓝兰,黄曙海,等.广西壮族自治区涂阳肺结核患者的耐药性分析[J].中国防痨杂志,2013,35(9):673-677.
[12]李无名,唐柳生,李勇,等.1067例结核病患者耐药情况分析[J].广西医学,2014,36(6):780-782.
[13]汪明,袁乐永,刘乐,等.MTBDRplus方法快速检测结核分枝杆菌耐药性的研究[J].国际呼吸杂志,2015,35(21):1601-1605.
[14]孙倩,张倩,张治国.Genotype MTBDRplus检测结核分枝杆菌耐药性的临床应用研究[J].国际检验医学杂志,2018,39(4):392-385.