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MAS-PCR 快速检测印度北部结核分枝杆菌临床分离株中 rpoB 和 katG 基因突变。

Rapid genotypic detection of rpoB and katG gene mutations in Mycobacterium tuberculosis clinical isolates from Northern India as determined by MAS-PCR.

机构信息

Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.

出版信息

J Clin Lab Anal. 2013 Jan;27(1):31-7. doi: 10.1002/jcla.21558.

Abstract

BACKGROUND

There is a growing need to develop rapid laboratory research methods to counter the menace of drug resistant tuberculosis (MDR-TB) cases worldwide especially in developing countries. The present study was undertaken to investigate the type and frequency of rpoB and katG mutations in rifampicin (RIF) and isoniazid (INH) resistant strains respectively of Mycobacterium tuberculosis (MTB) circulating in Northern India and to explore the utility of multiplex-allele-specific (MAS)-PCR assay for detection of drug-resistant MTB isolates in low resource set up.

METHODS

Phenotypic and genotypic drug susceptibility testing (DST) was performed on 354 MTB isolates.

RESULTS

Mutation in rpoB gene was found most frequently at codons 531, 526 and 516 (59.83%, 45.29% and 22.22%, respectively). Further, combinations of 2-3 point mutations were also observed in 19.66% of RIF-resistant MTB strains. The frequency of mutations in katG gene was found at codon 315 among 82.95% of the INH-resistant MTB isolates. MAS-PCR detected rpoB and katG mutations in phenotypically resistant isolates with sensitivities of 93% and 83% respectively.

CONCLUSION

MAS-PCR assays can be used for rapid detection of drug-resistant TB strains in routine diagnostic practice, enabling early administration of appropriate treatment regimens to the affected patients.

摘要

背景

全球范围内,尤其是在发展中国家,耐药结核病(MDR-TB)病例的威胁日益严重,因此迫切需要开发快速的实验室研究方法。本研究旨在调查印度北部流行的结核分枝杆菌(MTB)中利福平(RIF)和异烟肼(INH)耐药株的 rpoB 和 katG 突变的类型和频率,并探索多重等位基因特异性(MAS)-PCR 检测方法在资源有限的情况下用于检测耐药 MTB 分离株的实用性。

方法

对 354 株 MTB 分离株进行表型和基因型药物敏感性测试(DST)。

结果

rpoB 基因突变最常见于密码子 531、526 和 516(分别为 59.83%、45.29%和 22.22%)。此外,19.66%的 RIF 耐药 MTB 菌株还观察到 2-3 个点突变的组合。82.95%的 INH 耐药 MTB 分离株中 katG 基因突变发生在密码子 315。MAS-PCR 检测到表型耐药分离株中的 rpoB 和 katG 突变,其敏感性分别为 93%和 83%。

结论

MAS-PCR 检测方法可用于常规诊断实践中快速检测耐药性结核病菌株,使受影响的患者能够早期接受适当的治疗方案。

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