四川地区结核分枝杆菌katG、inhA和rpoB基因突变位点耐药水平及突变频率特征分析

目的 分析基因芯片法(芯片法)检测结核分枝杆菌(Mtb)katG、inhA和rpoB基因突变位点耐药水平、突变频率特征,为临床治疗提供参考依据.方法 选取成都市公共卫生临床医疗中心2020年1月—2021年1月收治的四川地区结核病患者118例Mtb分离株,芯片法通过katG、inhA和rpoB基因突变位点检测异烟肼(H...

Drug resistance and mutation frequency of katG,InhA and rpoB gene mutations in Mycobacterium tubercu-losis in Sichuan province

Objective To analyze the drug resistance level and mutation frequency of katG, InhA and rpoB gene mutations of Mycobacterium tuberculosis(MTB) by gene chip method, and to provide reference for clinical treatment.Methods 118 MTB isolates of tuberculosis patients from January 2020 to January 2021 in Chengdu public health clinical medical center were selected. Isoniazid(H) and rifampicin(R) resistance genes were detected by chip method using katG, InhA and rpoB gene mutation sites. The proportion method of microplate was used to detect the level of phenotypic drug resistance by culture and drug sensitivity test, and the relationship between gene mutation sites and drug resistance level and the distribution characteristics of mutation frequency were analyzed.Results The high drug resistance rates of H and R resistant strains were 83.53%(71/85) and 77.78%(77/99) respectively. There was a close relationship between gene mutation sites and drug resistance level. The H high resistance rates of katG and InhA single gene mutation sites were 92.96%(66/71) and 30.77%(4/13), respectively(χ²=26.28, P<0.05). The R high resistance rates of rpob531, rpob526 and rpob533/516/513/511 were 93.88%(49/49), 81.82%(18/22) and 37.50%(9/24) in rpoB single gene mutation sites(χ²=29.17, P<0.05). The mutation frequency of katg315 was 84.43%(71/85) in katg315 single gene, and rpob531(TCG → tTG) ser → Leu was the main mutation of R resistance related gene, and the mutation frequency was 49.50%(49/99).Conclusion The resistance level of H and R resistant strains is high in Sichuan. KatG and rpob531/526 are associated with high level of H and R resistance, InhA and rpob511/513/516/533 are associated with low level of H and R resistance. Katg315 and rpob531 are the main forms of H and R resistance related gene mutations. The clinical use of anti-tuberculosis drugs should be closely combined with drug sensitivity testing to develop a program.