Cavusoglu Cengiz, Turhan Ajda, Akinci Pinar, Soyler Ilknur
Ege University Medical Faculty, Department of Clinical Microbiology, Mycobacteriology Laboratory, 35100 Izmir, Turkey.
J Clin Microbiol. 2006 Jul;44(7):2338-42. doi: 10.1128/JCM.00425-06.
A novel PCR-based reverse hybridization method Genotype MTBDR assay (Hain Lifescience GmbH, Nehren, Germany) was evaluated for rapid detection of rifampin (RIF) and isoniazid (INH) resistance in Turkish Mycobacterium tuberculosis isolates. The Genotype MTBDR assay is designed to detect mutations within the 81-bp hotspot region of rpoB and mutations at katG codon 315. A total of 41 RIF-resistant M. tuberculosis isolates with rpoB mutations that were previously tested by the INNO-LiPA Rif.TB kit and also characterized by DNA sequencing were included in the study. Thirty-seven of these isolates were also resistant to INH. RIF resistance was correctly identified in 39 of 41 isolates (95.1%) with the Genotype MTBDR assay probes specific for these mutations. One isolate with a Gln-490-His mutation and another one with a CGG insertion between codons 514 and 515 were identified as RIF sensitive by the Genotype MTBDR assay. While the INNO-LiPA Rif.TB kit was able to determine the CGG insertion between codons 514 and 515, the Gln-490-His mutation outside the 81-bp hotspot region was not detected by the INNO-LiPA Rif.TB kit. These isolates had MICs of >or=32 microg/ml for RIF. The Genotype MTBDR assay also correctly identified 27 of 37 INH-resistant isolates (73%) with mutations in katG codon 315. In conclusion, the Genotype MTBDR assay may be useful for the rapid diagnosis of the most common mutations found in multidrug-resistant M. tuberculosis strains. However, the test results should always be confirmed with phenotypic methods.
一种基于聚合酶链反应(PCR)的新型反向杂交方法——基因型MTBDR检测法(德国内伦市海因生命科学有限公司),被用于评估土耳其结核分枝杆菌分离株中利福平(RIF)和异烟肼(INH)耐药性的快速检测。基因型MTBDR检测法旨在检测rpoB基因81碱基对热点区域内的突变以及katG基因第315密码子处的突变。本研究纳入了41株先前经INNO-LiPA Rif.TB试剂盒检测且经DNA测序鉴定具有rpoB基因突变的耐利福平结核分枝杆菌分离株。其中37株分离株同时对异烟肼耐药。使用针对这些突变的基因型MTBDR检测法探针,在41株分离株中有39株(95.1%)的利福平耐药性被正确鉴定。基因型MTBDR检测法将1株发生Gln-490-His突变的分离株和另1株在第514和515密码子之间有CGG插入的分离株鉴定为对利福平敏感。虽然INNO-LiPA Rif.TB试剂盒能够检测到第514和515密码子之间的CGG插入,但INNO-LiPA Rif.TB试剂盒未检测到81碱基对热点区域外的Gln-490-His突变。这些分离株对利福平的最低抑菌浓度(MIC)≥32μg/ml。基因型MTBDR检测法还正确鉴定出37株katG基因第315密码子发生突变的耐异烟肼分离株中的27株(73%)。总之,基因型MTBDR检测法可能有助于快速诊断耐多药结核分枝杆菌菌株中最常见的突变。然而,检测结果应始终通过表型方法进行确认。