Key Laboratory of Characteristic Infectious Disease & Bio-safety Development of Guizhou Province Education Department, Institute of Life Sciences, Zunyi Medical University, No.6 West Xuefu Road, Xinpu District, Zunyi, Guizhou Province, 563000, China.
Department of Microbiology, Zunyi Medical University, No.6 West Xuefu Road, Xinpu District, Zunyi, Guizhou Province, 563000, China.
Tuberculosis (Edinb). 2021 May;128:102083. doi: 10.1016/j.tube.2021.102083. Epub 2021 May 8.
Tuberculosis (TB) is an infectious disease that poses a serious threat to human health. Rifampin (RIF) is an important first-line anti-TB drug, and rifampin resistance (RIF-R) is a key factor in formulating treatment regimen and evaluating the prognosis of TB. Compared with other drugs resistance, the RIF-R mechanism of Mycobacterium tuberculosis (M. tuberculosis) is one of the clearest, which is mainly caused by RIF resistance-related mutations in the rpoB gene. This provides a convenient condition for developing rapid detection methods, and also an ideal object for studying the general drug resistance mechanisms of M. tuberculosis. This review focuses on the mechanisms that influence the RIF resistance of M. tuberculosis and related detection methods. Besides the mutations in rpoB, M. tuberculosis can decrease the amount of drugs entering the cells, enhance the drugs efflux, and be heterogeneous RIF susceptibility to resist drug pressure. Based on the results of current researches, many genes participate in influencing the susceptibility to RIF, which indicates the phenomenon of M. tuberculosis drug resistance is very complex.
结核病（TB）是一种严重威胁人类健康的传染病。利福平（RIF）是一种重要的一线抗结核药物，利福平耐药（RIF-R）是制定治疗方案和评估结核病预后的关键因素。与其他耐药性相比，结核分枝杆菌（M. tuberculosis）的 RIF-R 机制最清楚，主要是由于 rpoB 基因中的 RIF 耐药相关突变引起的。这为开发快速检测方法提供了便利条件，也是研究 M. tuberculosis 一般耐药机制的理想对象。本综述重点介绍了影响 M. tuberculosis 对利福平耐药的机制及相关检测方法。除了 rpoB 突变外，M. tuberculosis 还可以降低药物进入细胞的量，增强药物外排，并对异质性 RIF 药敏性产生抗药性压力。根据目前的研究结果，许多基因参与影响对 RIF 的敏感性，这表明 M. tuberculosis 耐药现象非常复杂。
