乌鲁木齐市耐多药结核分枝杆菌基因突变特征分析

目的 了解耐四种一线抗结核药物结核分枝杆菌的有关基因突变特征。方法 对19例耐多药结核病患者和254例全敏结核病患者痰液标本中分离的结核分枝杆菌进行药物敏感性试验，提取其DNA进行PCR扩增，对扩增产物测序并与标准株H37Rv进行比对。结果 19株耐多药结核杆菌和254株全敏结核杆菌均未检测到耐异烟肼基因inhA突变；耐多药组突变率最高的为耐异烟肼katG基因，突变位点为315；耐利福平的突变基因是rpoB，耐药位点为526和531，531位点突变率高于526位点；耐乙胺丁醇的突变基因是embB，耐药位点为206；耐链霉素的突变基因是rpsL和rrs，耐药位点分别为43和1401，rpsL基因的突变率高于rrs基因。结论 耐多药结核分枝杆菌耐异烟肼、利福平、乙胺丁醇、链霉素的突变基因分别为katG、rpoB、embB、rpsL和rrs，这对今后乌鲁木齐市耐多药结核病的快速诊断和控制提供了理论依据。

Analysis on gene mutation characteristics of multi-drug resistant mycobacterium tuberculosis in Urumqi City

Objective To understand the characteristics of gene mutation in four first-line anti tuberculosis drugs. Methods Mycobacterium tuberculosis strains were isolated from sputum samples of 19 MDR-TB infected patients and 254 sensitive TB infected patients for drug sensitivity tests. PCR amplification of DNA extracted from Mycobacterium tuberculosis was performed. The amplified products were sequenced and compared with the standard strain H37Rv. Results 19 strains of MDR-TB Mycobacterium and 254 strains of all sensitive TB Mycobacterium were not detected in isoniazid resistant inhA gene mutation. Multi drug resistant group mutation rate was the highest in isoniazid resistant gene katG, and mutation site of katG gene was 315. Rifampin resistant mutant gene was rpoB.RpoB resistant gene loci were 526 and 531, of which the mutation rate of 531 was higher than that of 526. Mutation of ethambutol resistance was embB, and embB gene resistance locus was 206. Streptomycin resistant mutant gene were rpsL and rrs, and the resistance locus of rpsL gene was 43, and the resistance locus of RRS gene was 1401, and the mutation rate of rpsL gene was higher than that of rrs gene. Conclusions katG, rpoB and embB, rpsL and rrs genes account for isoniazid, rifampicin, ethambutol and streptomycin multi-drug resistant mutation of mycobacterium tuberculosis. This study provides a theoretical basis for rapid diagnosis and control of multi drug resistant TB in the Urumqi city.