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目的研究青海地区耐乙胺丁醇结核分枝杆菌菌株embB基因突变特征,并比较耐乙胺丁醇(Ethambutol,EMB)菌株中耐多药结核分枝杆菌(Multiple drug resistance,MDR)与非结核分枝杆菌菌株的embB基因突变差异。方法采用聚合酶链式反应方法对63株耐乙胺丁醇的结核分枝杆菌的embB高突变区进行扩增,并分析embB基因突变特征。结果 63株耐乙胺丁醇的结核分枝杆菌中,28株在embB基因发生突变,突变率为44.44%(28/63);53株结核分枝杆菌且耐乙胺丁醇菌株中,22株(45.51%,22/53)在embB基因发生突变;10株非结核分枝杆菌耐乙胺丁醇菌株中,6株(60.00%,6/10)在embB基因发生突变。位点embB306和embB406为高突变点,分别占突变菌株的67.86%(19/28)和21.43%(6/28)。耐乙胺丁醇菌株中,结核分枝杆菌与非结核分枝杆菌菌株的embB基因突变差异无统计学意义(χ~2=0.536,P=20.464)。结论青海地区对乙胺丁醇耐药的结核分枝杆菌常见突变位点为embB306和embB406。单测embB基因不能非常有效地快速检测出乙胺丁醇耐药状况,增加emb A及其调控区的检测,能提高耐乙胺丁醇菌株的检出率。
Objective To investigate the mutation characteristics of embB gene of M.tuberculosis resistant to ethambutol in Qinghai and to compare the effect of multiple drug resistance (MDR) and non-tuberculosis (TB) in Ethambutol (EMB) Mutations in the embB Gene of Mycobacterium Strains. Methods The polymerase chain reaction (PCR) method was used to amplify the embB high mutation region of M.tuberculosis resistant to ethambutol and to analyze the mutation characteristics of embB gene. Results Of the 63 strains of M.tuberculosis resistant to ethambutol, 28 strains were mutated in the embB gene with a mutation rate of 44.44% (28/63). Among 53 strains of M. tuberculosis and ethambutol resistant, 22 Mutations in the embB gene occurred in 45.51% and 22/53 strains, respectively. Of the 10 strains of non-TB mycobacterium ethambutol resistant strains, 6 (60.00%, 6/10) mutated in the embB gene. The sites embB306 and embB406 were high mutation points, accounting for 67.86% (19/28) and 21.43% (6/28) of the mutant strains, respectively. There were no significant differences in embB gene mutations between M.tuberculosis and non-TB mycobacterium tuberculosis isolates (χ ~ 2 = 0.536, P = 20.464). Conclusion The common mutation sites of M. tuberculosis resistant to ethambutol in Qinghai are embB306 and embB406. The single test embB gene can not detect the resistance status of ethambutol very effectively and increase the detection of emb A and its regulatory region to increase the detection rate of ethambutol resistant strains.