本文選題：分枝桿菌　切入點：非典型性　出處：《中華疾病控制雜志》2017年01期 　論文類型：期刊論文

【摘要】：目的了解耐四種一線抗結核藥物結核分枝桿菌的有關基因突變特征。方法對19例耐多藥結核病患者和254例全敏結核病患者痰液標本中分離的結核分枝桿菌進行藥物敏感性試驗,提取其DNA進行PCR擴增,對擴增產物測序并與標準株H37Rv進行比對。結果 19株耐多藥結核桿菌和254株全敏結核桿菌均未檢測到耐異煙肼基因inhA突變;耐多藥組突變率最高的為耐異煙肼kat G基因,突變位點為315;耐利福平的突變基因是rpo B,耐藥位點為526和531,531位點突變率高于526位點;耐乙胺丁醇的突變基因是emb B,耐藥位點為206;耐鏈霉素的突變基因是rps L和rrs,耐藥位點分別為43和1401,rps L基因的突變率高于rrs基因。結論耐多藥結核分枝桿菌耐異煙肼、利福平、乙胺丁醇、鏈霉素的突變基因分別為kat G、rpo B、emb B、rps L和rrs,這對今后烏魯木齊市耐多藥結核病的快速診斷和控制提供了理論依據。
[Abstract]:Objective to investigate the characteristics of gene mutations in mycobacterium tuberculosis resistant to four first-line anti-tuberculosis drugs. Methods Drug sensitivity tests were performed in sputum samples of 19 patients with multidrug-resistant tuberculosis and 254 patients with hypersensitive tuberculosis. The DNA was extracted for PCR amplification, the amplified products were sequenced and compared with the standard strains H37Rv. Results No inhA mutation of isoniazid resistant gene was detected in 19 strains of multidrug resistant Mycobacterium tuberculosis and 254 strains of allelic Mycobacterium tuberculosis. The mutation rate of isoniazid resistant kat G gene was the highest in multidrug resistance group, and the mutation rate of rifampicin-resistant gene was rpo B, and the mutation rate of resistant site 526 and 531531 was higher than that of isoniazid resistance gene, and the mutation rate of rifampicin-resistant gene was higher than that of isoniazid resistance group. The mutant gene resistant to ethambutanol is emb B with a drug resistance site of 206, and streptomycin resistant mutant gene is rps L and rrs. The mutation rate of resistant locus is 43 and 1401 rps L, respectively, which is higher than that of rrs gene. Conclusion the multidrug resistant Mycobacterium tuberculosis is isoniazid and rifampicin resistant to isoniazid and rifampicin. The mutated genes of ethambutanol and streptomycin are kat Gnrpo Bemb Bnrps L and rrs, respectively, which provides a theoretical basis for the rapid diagnosis and control of MDR-TB in Urumqi.
【作者單位】： 新疆醫(yī)科大學公共衛(wèi)學院流行病與衛(wèi)生統(tǒng)計教研室;烏魯木齊市疾病預防控制中心結核病防治科;新疆軍區(qū)疾病預防控制中心消殺滅科;
【基金】：新疆維吾爾自治區(qū)自然科學基金項目(201442137-20) 烏魯木齊市衛(wèi)生局科學技術計劃項目(201313)
【分類號】：R52

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