39株对克拉霉素耐药的结核分枝杆菌临床分离株23SrRNA检测结果分析

目的 分析对克拉霉素耐药的结核分枝杆菌临床分离株23S rRNA的A2058位点的变化。 方法 选择我院菌株库的结核分枝杆菌临床分离株64株，其中10株为对全部抗结核药物敏感的结核分枝杆菌临床分离株；14株为单耐克拉霉素的结核分枝杆菌临床分离株；15株为耐多药，同时耐克拉霉素的结核分枝杆菌临床分离株；15株为耐多药，同时对克拉霉素敏感的结核分枝杆菌临床分离株；10株为广泛耐药菌株，同时对克拉霉素耐药的结核分枝杆菌临床分离株；此外，还有结核分枝杆菌标准株H37Rv 1株。对结核分枝杆菌23S rRNA行PCR检测和测序。 结果 经检测，H37Rv标准株没有A2058突变，只有1株广泛耐药临床分离株检测有A2058A-G的突变，其他临床分离株均没有突变，在耐克拉霉素的结核分枝杆菌临床分离株中占2.56%（1/39），在广泛耐药结核分枝杆菌临床分离株中占1/10。 结论 结核分枝杆菌临床分离株对克拉霉素耐药的机制中， A2058突变可能不是产生对克拉霉素耐药的主要机制。结核分枝杆菌产生对克拉霉素耐药的机制有待进一步研究。

Analyses of 23S rRNAs of 39 clarithomycin-resistant Mycobacterium tuberculosis clinical isolates

Objective To investigate the changes of 23S rRNA at site 2058 of clarithromycin-resistant Myco- bacterium tuberculosis clinical isolates. Methods One Mycobacterium tuberculosis H37Rv standard strain and 64 iso- lates were detected, in which 39 clarithromycin-resistant isolates, 25 clarithromycin-sensitive isolates. The 23S rRNAs of Mycobacterium tuberculosis isolates were analyzed by polylnerase chain reaction （PCR） and sequencing. Results The 23S rRNA of Mycobacterium tuberculosis H37Rv standard strain did not found the mutation at site 2058. Of 64 Mycobacterium tuberculosis isolates, only 1 extensively drug-resistant （XI）R） strain had A2058A-G mu- tation of 23S rRNA, which account 2.56% （1/39） clarithromycin-resistant strains and 1/10 XDR strains. Conclusion The mutation of 23S rRNA at site 2058 of Mycobacterium tuberculosis may not be the main cause inducing its clarithromycin resistance. The mechanism of Mycobacterium tuberculosis clarithromycin resistance need be further studied.