Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Braz J Infect Dis. 2012 Jan-Feb;16(1):57-62. doi: 10.1016/s1413-8670(12)70275-1.
Isoniazid (INH) and rifampin (RIF) are the most effective first line antibiotics against Mycobacterium tuberculosis. Mutations in several genes determine resistance of M. tuberculosis to INH, with the most common gene target of katG, and resistance to RIF is due to mutation in rpoB gene. The aim of present study was to assess the mutations in the regions related to RIF and INH resistance.
We characterized 80 clinical isolates of confirmed M. tuberculosis to analyze the most commonly observed INH and RIF mutations. PCR analysis and sequencing were used to detect mutations related to RIF and INH resistance. The multiplex allele-specific-PCR (MAS-PCR) was performed as a comparative assay and for evaluation of this method.
The sequencing of the 250-bp region of katG codon 315, revealed point mutations at 5 different codons in 13.7% of the M. tuberculosis isolates. The sequencing of the 270-bp central region of the rpoB gene revealed point mutations at 7 different codons in 12 (15%) of the M. tuberculosis isolates. The results obtained with MAS-PCR are in accordance with PCR-sequencing with high sensitivity and specificity for katG315, inhA15, and rpoB (531, 516, 526).
The results of this study suggested that molecular techniques can be used as a rapid tool for the identification of drug resistance in clinical isolates of M. tuberculosis. Both DNA sequencing and MAS-PCR yielded high sensitivity for the detection of RIF and INH mutations and detecting multi-drug resistant tuberculosis cases.
异烟肼(INH)和利福平(RIF)是抗结核分枝杆菌最有效的一线抗生素。几种基因的突变决定了结核分枝杆菌对 INH 的耐药性,最常见的基因靶标是 katG,而对 RIF 的耐药性则是由于 rpoB 基因突变。本研究旨在评估与 RIF 和 INH 耐药相关的突变。
我们对 80 株确诊的结核分枝杆菌临床分离株进行了特征分析,以分析最常见的 INH 和 RIF 突变。采用 PCR 分析和测序来检测与 RIF 和 INH 耐药相关的突变。采用多重等位基因特异性 PCR(MAS-PCR)作为对照试验,并对该方法进行评估。
对 katG 密码子 315 250 个碱基的测序,显示在 13.7%的结核分枝杆菌分离株中,有 5 个不同密码子的点突变。对 rpoB 基因 270 个碱基的中心区域进行测序,显示在 12 株(15%)结核分枝杆菌分离株中有 7 个不同密码子的点突变。MAS-PCR 的结果与 PCR 测序高度一致,对 katG315、inhA15 和 rpoB(531、516、526)具有高灵敏度和特异性。
本研究结果表明,分子技术可作为快速鉴定临床分离株结核分枝杆菌耐药性的工具。DNA 测序和 MAS-PCR 均对 RIF 和 INH 突变的检测具有较高的灵敏度,可用于检测耐多药结核病例。