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目的探讨江苏省结核分枝杆菌耐药相关基因的基因型特点及其与耐药表型的关系,为开展耐药结核病快速诊断提供依据。方法通过基因测序技术,分析结核分枝杆菌利福平(rifampin,RFP)耐药相关基因rpoB和异烟肼(isoniazid,INH)耐药相关基因katG不同位点的突变频率,探讨基因型与耐药表型的关系。结果共收集新登记涂阳病人菌株283株,其中255株结核分枝杆菌成功测序,包括38株RFP耐药株,50株INH耐药株,48株链霉素耐药菌株,21株乙胺丁醇耐药株,34株耐多药菌株。28株(11.0%)在rpoB 81bp的基因核心区发生了点突变,21株出现单个位点突变外,7株出现两位点突变,突变形式主要为rpoB531 TCG→TTG单个位点突变。30株(11.8%)发生了katG基因区的突变,所有突变形式为katG315AGC→ACC。rpoB基因突变全部发生于RFP耐药菌株中,katG基因突变全部发生于INH耐药菌株中。结论检测rpoB与katG基因位点的突变对判断江苏省地区耐药结核以及耐多药结核有重要的价值,可以为开展耐药结核病早期诊断提供科学依据。
Objective To investigate the genotypes of Mycobacterium tuberculosis resistance-related genes in Jiangsu Province and its relationship with drug resistance phenotypes, and to provide a basis for rapid diagnosis of drug-resistant tuberculosis. Methods The frequency of mutations of ratA gene and resistance gene katG of isoniazid (INH) gene of Mycobacterium tuberculosis was analyzed by gene sequencing technique to investigate the relationship between genotype and resistance Drug phenotypes of the relationship. Results A total of 283 new strains of smear-positive patients were collected. Among them, 255 strains of Mycobacterium tuberculosis were successfully sequenced, including 38 RFP-resistant strains, 50 INH-resistant strains, 48 streptomycin- Butanol resistant strains, 34 multidrug-resistant strains. 28 strains (11.0%) had point mutations in the gene core region of rpoB 81bp, 21 strains had a single locus mutation, and 7 strains showed two locus mutations. The mutation was mainly rpoB531 TCG → TTG single locus mutation. Thirty (11.8%) katG gene regions were mutated and all the mutated forms were katG315AGC → ACC. All rpoB mutations occurred in RFP-resistant strains, and katG mutations all occurred in INH-resistant strains. Conclusion The detection of mutations in rpoB and katG loci has important value in judging drug-resistant TB and multidrug-resistant tuberculosis in Jiangsu Province, which may provide a scientific basis for early diagnosis of drug resistant TB.