结核分枝杆菌eis 基因突变与氨基糖苷耐药的研究

目的:探讨结核分枝杆菌eis基因突变与氨基糖苷耐药之间的相互关系。方法:以本室保存的35株已确定耐一线药物(异烟肼、利福平、乙胺丁醇、链霉素)的结核分支杆菌为研究对象,应用BECTEC960测定其二线药物(阿米卡星、卡那霉素)的耐药情况,同时应用基因测序的方法测定结核分枝杆菌eis基因突变情况,分析eis基因突变与氨基糖苷耐药之间的相互关系。结果:氨基糖苷耐药的部分结核分杆杆菌中,eis基因487位碱基出现突变,相应的163位氨基酸密码子由CGT突变为CAT,即由缬氨酸变为异亮氨酸。结论:eis基因V163I突变(缬氨酸变为异亮氨酸)可能与结核分枝杆菌耐氨基糖苷类药物有关。     

结核分枝杆菌eis基因突变与氨基糖苷耐药的研究

目的：探讨结核分枝杆菌eis基因突变与氨基糖苷耐药之间的相互关系。方法：以本室保存的35株已确定耐一线药物（异烟肼、利福平、乙胺丁醇、链霉素）的结核分支杆菌为研究对象,应用BECTEC960测定其二线药物（阿米卡星、卡那霉素）的耐药情况,同时应用基因测序的方法测定结核分枝杆菌eis基因突变情况,分析eis基因突变与氨基糖苷耐药之间的相互关系。结果：氨基糖苷耐药的部分结核分杆杆菌中,eis基因487位碱基出现突变,相应的163位氨基酸密码子由CGT突变为CAT,即由缬氨酸变为异亮氨酸。结论：eis基因V163I突变（缬氨酸变为异亮氨酸）可能与结核分枝杆菌耐氨基糖苷类药物有关。     

深圳地区结核分枝杆菌耐利福平株rpoB基因突变分布

目的:调查深圳地区结核分枝杆菌耐利福平(RFP)株rpoB基因突变的分布情况,建立结核分枝杆菌耐药基因快速检测的方法.方法:对55株结核分枝杆菌临床分离株的rpoB基因280个碱基(包括其核心区75个碱基)应用PCR-直接测序法(PCR-DS)测定序列,其中耐利福平株51株,敏感株4株.结果:4株敏感株无突变,92.2%(47/51)耐利福平临床分离株存在rpoB基因突变.基因突变导致531位氨基酸突变率为41.2%(21/51);导致526位氨基酸突变率为29.4%(15/51);导致516位氨基酸突变率为13.7%(7/51).联合突变发生率为2.0%(1/51).未检测到发生缺失或插入碱基突变的菌株.结论:深圳地区结核分枝杆菌耐利福平株发生rpoB基因突变最常见的是531位丝氨酸、526位组氨酸和516位天冬氨酸的基因突变,三者突变率之和为84.3%(43/51).PCR-DS方法可快速测定结核分枝杆菌RFP耐药基因突变.     

结核分枝杆菌临床株4种耐药基因的检测与分析

结核分枝杆菌Mycobacterium tuberculsis(M.t)4种耐药基因的研究,了解耐药基因突变情况和耐药水平的关系。108例临床痰标本临床分离株均做传统梯度药敏试验和聚合酶链反应多态-单链构象多态性（PCR-SSCP）试验。结果表明耐SM（rpsL）REP(rpoB）INH(katG）EMB（embB）基因突变率分别为78.5%,68.2%,70.5%,48.6%。其中,上海高耐药株基因突变率分别为86.5%,89.3%,84.3%,35.3%。低耐药株分别为28.5%,16.5%,7.1%。EMB在低耐药区无基因突变。M.t的4种耐药基因联合检测的分析,在国内外很少报道。部分M.t的耐药由耐药基因突变所致,M.t耐药基因突变与耐药水平密切相关,且M.t基因突变绝大多数发生在高耐药区中,也有少部分在低耐区株中发生。     

201例结核病患者分离株的药敏结果分析

本文旨在分析2008年12月～2009年5月就诊于上海市肺科医院的201例结核病患者结核分枝杆菌的药敏试验结果。结核分枝杆菌培养采用罗氏培养系统,药敏试验采用绝对浓度法。201例患者中,耐药率由高到低依次为异烟肼(INH,52.24%)、链霉素(SM,45.77%)、利福平(RFP,30.35%)、乙胺丁醇(EMB,28.86%)、阿米卡星(AK,28.18%)、利福喷汀(RIB,26.40%)、力克肺疾(Pa,25.56%)、对氨基水杨酸(PAS,23.60%)、丙硫异烟胺(Pt,23.03%)、卷曲霉素(CPM,20.56%)。其中,初治患者的耐药率为3.08%～26.15%,复治患者为27.50%～64.71%,耐多药患者为64.44%～100%。总体来看,与低浓度相比,高浓度SM、INH、EMB、RIB、Pt可明显降低结核分枝杆菌的耐药率(P0.05)。除INH、SM、RFP外,女性患者的耐药率均高于男性,耐多药率亦高于男性(P0.05)。结果提示,临床上应足量应用抗结核药物,对女性结核病患者要给予更多关注。     

儿童结核病耐药状况及危险因素分析

目的了解最新儿童耐药结核病流行现状,为耐药儿童结核病的预防、控制提供依据。方法于2006年6月至2009年6月间收集了重庆医科大学附属儿童医院161例结核病患儿样本,采用比例法对链霉素(Streptomycin,SM)、异烟肼(Isoniazide,INH)、利福平(Rifampicin,RFP)、乙胺丁醇(Ethambutol,EMB)和吡嗪酰胺(Pyrazinamide,PZA)共5种药物进行耐药性测定。结果 161株菌株中鉴定出139例为结核分枝杆菌,对这139例培养阳性儿童结核病例中,总耐药率和总耐多药率分别为20.86%、6.47%,平均耐药率顺位由高到低是SM(12.2%)、INH(10.79%)、RFP(8.63%)、EMB(2.88%)、PZA(2.88%)。结论重庆地区儿童结核病总体耐药及耐多药水平低于全国平均水平,城镇地区及复治患儿可能是儿童结核病病例发生多耐药的相关因素。     

结核分枝杆菌临床株4种耐药基因的检测与分析*

结核分枝杆菌 Mycobacterium tuberculsis（M.t）4种耐药基因的研究,了解耐药基因突变情况和耐药水平的关系。108例临床痰标本临床分离株均做传统梯度药敏试验和聚合酶链反应多态-单链构象多态性（PCR-SSCP）试验。结果表明耐SM（rpsL）REP（rpoB）INH（katG）EMB（embB）基因突变率分别为78.5％,68.2％,70.5％,48.6％。其中,上述高耐药株基因突变率分别为86.5％,89.3％,84.3％,35.3％。低耐药株分别为28.5％,16.5％,7.1     

MprAB双组分系统基因在耐药MTB中的表达水平分析

目的:分析结核分枝杆菌(Mycobacterium tuberculosis,MTB)临床分离株对4种一线抗结核药物的耐药情况以及结核分枝杆菌双组份系统Mpr AB与MTB耐药性的相关性。方法:收集本地区确诊的结核病患者痰液标本,分离培养得到的MTB菌株进行4种一线抗结核药物异烟肼(Isoniazid,H)、利福平(Rifampicin,R)、链霉素(Streptomycin,S)和乙胺丁醇(Ethambutol,E)的耐药性检测并比较双组分系统Mpr AB编码基因(Mpr A、Mpr B)在MTB标准株(H37Rv)、耐异烟肼(H-MTB)、耐利福平(R-MTB)、耐链霉素(S-MTB)、耐乙胺丁醇(E-MTB)和耐多药(Multi-drug Resistant MTB,M-MTB)菌株中的表达量。结果:分离培养得到72株分枝杆菌,对一种抗结核药物具有耐药性的有19株(H 8株、S 5株、R 3株、E 3株),耐药率为26.39%,对二种及以上耐药的有6株,耐多药率为8.33%(6/72)。Mpr A在H37Rv、H-MTB、R-MTB、S-MTB、E-MTB、M-MTB各组相对表达量分别为:1.12±0.07、3.34±0.42、4.16±0.46、3.09±0.24、2.27±0.18、8.43±0.63,Mpr B在各组相对表达量分别为:5.71±0.59、2.42±0.22、1.47±0.11、2.28±0.23、2.09±0.15、0.54±0.03。Mpr A和Mpr B基因在H37Rv与各耐药组之间比较差异有统计学意义(p0.05),Mpr A和Mpr B基因在各单耐药组与MDR组之间比较有统计学意义,而Mpr A和Mpr B基因在各单耐药组间比较均无统计学意义。结论:Mpr AB双组分系统与MTB耐药性的产生有一定的相关性。     

结核分枝杆菌乙胺丁醇耐药机制的研究进展

耐多药结核病的出现和流行对结核病的防控造成了严重威胁。乙胺丁醇(Ethambutol, EMB)是一线抗结核药物,常与异烟肼、利福平等联合应用,还可用于耐药结核病的治疗。但近年来EMB耐药形势严峻,我国复治结核病患者中EMB耐药率已达17.2%,并呈上升趋势;耐多药结核病患者中,EMB耐药率约为51.3%~66.7%,情况不容乐观。明确EMB耐药的产生机制对于有效防控EMB耐药率的上升、充分发挥EMB的作用十分重要,因此本文对结核分枝杆菌EMB的耐药现状、EMB的作用机制及其耐药产生机制方面的研究进展进行了综述。     

结核分枝杆菌耐药机制研究进展

结核分枝杆菌为结核病的病原体.最近几年,由于基因突变导致多耐药及广泛耐药结核菌株的出现,以及抗结核病药近几十年来没有换代,使之前基本得到控制的结核痛死灰复燃,成为世界上病死率最高的传染病.为了遏制其进一步的恶化,必须从根本上透彻了解其耐药分子机制.近年来,各国学者采用先进分子生物学技术对结核杆菌耐药机制进行深入研究,定位了结核分枝杆菌耐药基因的位置和基因突变位点,比如耐异烟肼、利福平、乙胺丁醇、链霉素、吡嗪酰胺、喹诺酮类、外排泵等菌株新的基因突变位点引起新的功能改变有新的发现,特别是gidB基因、外排泵基因等有突破性的发现,对研制新一代抗结核病药提供了理论支持及新的方向,但仍有很多耐药机制未阐明,为后续研究者提供些许查考,故笔者就近几年来从分子水平对耐药机制的研究进展做一概述.     

结核分枝杆菌三种耐药基因的检测方法

建立3种结核分枝杆菌耐药基因的检测方法,探讨耐药基因突变与耐药性的关系。将58株临床分离株均做聚合酶链反应-单链构象多态性分析(PCR—SSCP)和传统药物敏感试验。结果表明,结核分枝杆菌耐药基因突变与耐药水平有密切联系,绝大多数结核分枝杆菌耐药基因突变发生在高耐药株,少部分在低耐药株发生基因突变。     

结核分枝杆菌katG基因突变的研究

探讨编码过氧化氢-过氧化物酶的katG基因突变与结核分枝杆菌异烟肼(INH)耐药性的相关关系。根据结核分枝杆菌GenBank中的katG序列,自行设计特异性寡聚核苷酸引物,采用聚合酶链反应-单链构象多态性(PCR-SSCP)分析和直接测序法(DS)分析结核分枝杆菌中katG基因突变情况。以HR37Rv标准株为对照。所有23株敏感菌均未有SSCP结果异常;35株耐药菌中,有2株(5．7％)katG基因扩增阴性,且发生在高度耐药菌中。进一步分析发现,SSCP法突变检出23株(65．7％),测序法突变检出24株(68．6％),符合率为95．8％(23／24)。参照测序法对耐药菌突变序列的分析结果,PCR—SSCP敏感、特异,可快速检测结核分枝杆菌katG耐药基因突变,有利于耐药结核分枝杆菌耐药性的快速检测。     

结核分枝杆菌rpoB基因突变的检测(简报)

结核病主要是由结核分枝杆菌(Mycobacterium tuberculosis)引起的一种慢性传染性疾病。利福平是结核病化疗方案中一个关键性的药物,它在结核病的短程化疗中起着重要的作用。但是,在我国结核菌对利福平的耐药发生率呈上升局势,而通过传统的依赖生物生长的药敏试验方法进行结核菌对利福平耐药性检测所需时间较长(4-8周),不能满足临床早期开展有效化疗的需要,所以迫切需要建     

A Pyrosequencing assay for rapid recognition of SNPs in Mycobacterium tuberculosis embB306 region

Ethambutol (EMB) is in use worldwide as a first-line anti-tuberculosis drug and substitutions in codon 306 of the embB gene are the most common mutations found in EMB resistant Mycobacterium tuberculosis (MTB) strains. Pyrosequencing is a real time sequencing method able to rapidly detect mutations in a large number of samples. Using this technique we analyzed, in parallel with conventional sequencing, a 24 bp region of the embB gene of 28 MTB clinical isolates. Pyrosequencing efficiently identified all embB306 mutations, detecting three different single-base substitutions leading to 2 amino acid changes (Met to Val or Ile). Mutated embB alleles were detected in 2 multidrug-resistant (MDR) EMB-susceptible strains. Overall, our results demonstrated that the Pyrosequencing method efficiently recognizes mutations in embB in a very short time and represents a valid molecular method to detect mutations in the MTB embB306 region.     

Detection of rifampin resistance patterns in Mycobacterium tuberculosis strains isolated in Iran by polymerase chain reaction-single-strand conformation polymorphism and direct sequencing methods

Mutations in the rpoB locus confer conformational changes leading to defective binding of rifampin (RIF) to rpoB and consequently resistance in Mycobacterium tuberculosis. Polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) was established as a rapid screening test for the detection of mutations in the rpoB gene, and direct sequencing has been unambiguously applied to characterize mutations. A total of 37 of Iranian isolates of M. tuberculosis, 16 sensitive and 21 resistant to RIF, were used in this study. A 193-bp region of the rpoB gene was amplified and PCR-SSCP patterns were determined by electrophoresis in 10% acrylamide gel and silver staining. Also, 21 samples of 193-bp rpoB amplicons with different PCR-SSCP patterns from RIFr and 10 from RIFs were sequenced. Seven distinguishable PCR-SSCP patterns were recognized in the 21 Iranian RIFr strains, while 15 out of 16 RIFs isolates demonstrated PCR-SSCP banding patterns similar to that of sensitive standard strain H37Rv. However one of the sensitive isolates demonstrated a different pattern. There were seen six different mutations in the amplified region of rpoB gene: codon 516(GAC/GTC), 523(GGG/GGT), 526(CAC/TAC), 531(TCG/TTG), 511(CTG/TTG), and 512(AGC/TCG). This study demonstrated the high specificity (93.8%) and sensitivity (95.2%) of PCR-SSCP method for detection of mutation in rpoB gene; 85.7% of RIFr strains showed a single mutation and 14.3% had no mutations. Three strains showed mutations caused polymorphism. Our data support the common notion that rifampin resistance genotypes are generally present mutations in codons 531 and 526, most frequently found in M. tuberculosis populations regardless of geographic origin.     

Characterization of rpoB mutations associated with rifampin resistance in Mycobacterium tuberculosis from eastern China

Aims:  The aim of this study was to investigate the features of rpoB gene mutations associated with Rifampin (RIF) resistance in Mycobacterium tuberculosis ( M. tuberculosis ) in eastern China.
Methods and Results:  The mutations of rpoB gene in 56 clinical isolates of M. tuberculosis resisted to one to four first-line drugs (rifampin, isonicotinyl hydrazide, ethambutol and streptomycin) were analysed by polymerase chain reaction single strand conformation polymorphism analysis (PCR-SSCP) and DNA sequencing. The results of PCR-SSCP showed 52 isolates were positive (existing rpoB mutation) including 47 isolates resisted to RIF. Subsequent results of DNA sequencing showed that 54 isolates had rpoB gene mutation including 49 isolates resisted to RIF. The most frequently mutated sites were at codons 526 (73·2%), 513 (10·7%) and 531 (3·5%).
Conclusions:  The rpoB codon 526 was the most frequently mutated site of RIF-resistant M. tuberculosis strains in eastern China and its frequency is significantly higher ( P  < 0·0001) compared with that in other areas of China and in other geographic regions worldwide.
Significance and Impact of the Study:  Our results reveal that geographic variation is responsible for rpoB mutations in M. tuberculosis and the resulting information will be helpful to improve a novel rapid molecular drug resistance screening approach for MDR TB.     

The EMB 506 gene encodes a novel ankyrin repeat containing protein that is essential for the normal development of Arabidopsis embryos

The EMB 506 gene of Arabidopsis, required for the normal development of the embryo beyond the globular stage, has been cloned. The gene encodes a protein of predicted size 35 kDa that contains five ankyrin (ANK) repeats within the C terminal moiety. ANK repeats are conserved domains of 33 amino acids involved in specific recognition of protein partners. The EMB 506 protein was detected at different stages of silique development but accumulated preferentially in the mature cauline leaves. The rescue of homozygous emb 506 embryos by complementation with the wild-type sequence cDNA demonstrated that the emb mutation is a consequence of the T-DNA insertion and that integration and expression of the transgene occurred during gametogenesis and/or early embryo development. In addition to the drastic effect of the emb 506 mutation during embryo development, complementation experiments revealed another effect of the gene: emb 506 plants transformed with the wild-type EMB 506 sequence were able to produce viable seeds but showed a reduction of apical dominance and the presence of adventitious buds or bracts along the stem. This result supports the idea that genes essential for embryogenesis may also be required at other stages of the plant life cycle.     

Nucleotide Polymorphism Associated with Ethambutol Resistance in Clinical Isolates of Mycobacterium tuberculosis

Ethambutol (EMB) is a first-line drug used for antitubercular therapy in combination with other drugs as recommended by World Health Organization DOTS/DOTS-Plus regimens. EMB is also effective in the treatment of opportunistic mycobacterial infections in patients with human immunodeficiency virus. The emb locus has been considered as a drug target for EMB, and substitutions of codon 306 in Mycobacterium tuberculosis gene embB have been shown to be the most frequent and predictive mutations for EMB resistance. The aim of the present study was to detect embB and embC gene mutations in EMB-resistant clinical isolates. A total of 23 isolates of M. tuberculosis from patients with pulmonary tuberculosis were included in the study. Drug sensitivity was tested by proportion method and E-test. All 23 isolates were EMB resistant. Primers to amplify the embB and embC gene were designed, and polymerase chain reaction products were subjected for sequence analysis. H37Rv standard laboratory strain was used as control. Nucleotide sequencing showed that 16 strains had a mutation in the embB gene. The most common mutation observed in the embB gene was at codon 306, followed by mutations at codons 299 and 378 in 4 and 2 isolates, respectively. Novel mutations have been reported at codons 239, 240, 247, 282, 311, 368, 397, 446, 469, and 471. Sequence analysis of the embC gene showed mutation in 8 isolates at codon 270. Novel mutations in embC have been reported at codons 251 and 254. The most common nucleotide polymorphism in our isolates was at codons 306 and 299 in the embB gene and at codon 270 in the embC gene. A mutation at codon 306 was usually associated with high-level ethambutol resistance.     

结核耐药基因的基因芯片检测及临床应用

目的:采用基因芯片技术对结核分枝杆菌中常见耐药基因rpoB、katG及inhA进行检测,以了解结核分枝杆菌的耐药情况,及基因芯片技术检测结核菌耐药基因的临床应用价值。方法:收集40例涂片抗酸染色阳性并经分枝杆菌菌种鉴定芯片鉴定为结核的样本进行结核耐药基因检测。结果:40例样本中,14例无法判读结果,占35%,检出26例,检出率为65%。其中,无突变的野生型21例,占52.5%;突变型5例,总突变率为12.5%;3例rpoB基因的531点单独突变(TCG→TTG),突变率为7.5%;2例katG基因的315点单独突变(AGC→ACC),突变率为5%。结论:结核耐药基因芯片试剂盒检测结核菌耐药基因时针对单个菌落,用痰样本直接检测耐药基因虽能简便快速地了解结核分枝杆菌的耐药情况,但会出现一些无法判读的结果,原因须进一步探讨。