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目的研究耐多药结核分枝菌中emb B基因突变与乙胺丁醇耐药的相关性。方法比例法检测84株耐多药结核分枝杆菌的乙胺丁醇(EMB)耐药性,基因测序检测emb B基因的突变,χ2检验分析二者之间的相关性。结果84株耐多药结核分枝杆菌中有43株(51.2%)对EMB耐药,41株(48.8%)对EMB敏感,57株耐多药菌株(67.9%)的emb B基因发生突变。在43株EMB耐药菌株中,emb B基因突变的菌株为40株(93.0%),而41株EMB敏感菌株中,emb B基因突变的菌株为17株(41.5%),emb B基因在耐药菌株中的突变频率远高于敏感菌株(χ2=25.58,P=0.00)。emb B306是最常见的突变位点,其在耐药菌株的突变率也高于敏感菌株(χ2=12.37,P=0.00),emb B基因和emb B306位点检测EMB耐药的敏感度、特异度和准确性分别为93.0%和65.1%,58.5%和73.2%,76.2%和69.0%。结论 EMB耐药的产生与emb B基因和emb B306突变有关,二者用于检测EMB耐药有一定的参考意义。
Objective To study the relationship between emb B gene mutation and ethambutol resistance in multidrug-resistant Mycobacterium tuberculosis. Methods The drug resistance of 84 multidrug-resistant Mycobacterium tuberculosis et al (EMB) was detected by proportional method. Mutations of emb B gene were detected by gene sequencing. The correlation between them was analyzed by χ2 test. RESULTS: Of the 84 multidrug-resistant mycobacteria, 43 (51.2%) were resistant to EMB, 41 (48.8%) were sensitive to EMB, and the emb B gene of 57 multi-drug resistant strains (67.9%) were mutated. Of the 43 EMB-resistant strains, 40 (93.0%) were those with emb B gene mutation and 17 (41.5%) were those with emb B gene mutation in 41 EMB-sensitive strains. Emb B gene was resistant to The frequency of mutation in drug-resistant strains was much higher than that in susceptible strains (χ2 = 25.58, P = 0.00). The mutation of emb B306 was the most common mutation in drug-resistant strains. The mutation rate of emb B gene and emb B306 was also higher than that of susceptible strains (χ2 = 12.37, P = 0.00) Degree and accuracy were 93.0% and 65.1%, 58.5% and 73.2%, 76.2% and 69.0% respectively. Conclusions The generation of EMB resistance is related to the mutation of emb B gene and emb B306, both of which are useful for the detection of EMB resistance.