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目的:了解丽水地区结核分枝杆菌耐INH分离株KatG基因突变情况。方法:采用PCR-DNA直接测序法对48株结核分枝杆菌临床分离株KatG基因与耐INH关系密切的突变位点进行分析。结果:药敏试验共获得INH耐药结核菌12株,INH敏感结核菌36株,耐药株占25.00%(12/48);KatG基因第315位和第463位未见碱基的插入或缺失,其中有37株存在点突变,突变率为77.08%,有9株发生在S315:AGC→ACC(Ser→Thr),均为INH耐药菌株;有37株发生在R463:CGG→CTG(Arg→Leu),其中有9株为INH耐药菌株,28株为INH敏感菌株;S315和R463同时发生突变的有9株,均为INH耐药菌株;有11株均未发生突变,其中3株为INH耐药菌株。结论:丽水地区部分结核分枝杆菌耐INH是由于其KatG基因耐药位点(尤其是S315)突变所致,与药敏试验吻合率为100%;KatG基因R463/L突变无意义;有3株药敏试验耐药菌未发现S315和/或R463耐药位点突变,可能还存在其它耐药机制,需要进一步研究证实。
Objective: To understand the mutation of KatG gene of INH isolates from Mycobacterium tuberculosis in Lishui area. Methods: PCR-DNA direct sequencing method was used to analyze the mutation sites of 48 strains of Mycobacterium tuberculosis clinical isolates that are closely related to INH. Results: There were 12 strains of INH-resistant tuberculosis and 36 strains of INH-susceptible tubercle bacilli in resistance-susceptibility test. The resistant strains accounted for 25.00% (12/48). The 315th and 463th KatG genes had no insertion or Among them, 37 were found to have point mutations with a mutation rate of 77.08%. Nine of them were found to be INH-resistant strains in S315: AGC → ACC (Ser → Thr), 37 in R463: CGG → CTG Arg → Leu). Among them, 9 strains were INH resistant strains and 28 strains were INH sensitive strains. Nine strains with simultaneous mutation of S315 and R463 were INH resistant strains. No mutation occurred in 11 strains, of which 3 Strain for INH resistant strains. Conclusion: The resistance to INH of some Mycobacterium tuberculosis strains in Lishui region was due to the mutation of the KatG gene (especially S315), and the coincidence rate with susceptibility test was 100%. The R463 / L mutation of KatG gene was of no significance. Strain susceptibility test strains found S315 and / or R463 resistance mutations, there may be other resistance mechanisms need further study confirmed.