链霉素耐药结核分支杆菌rpsL基因分析

结核分支杆菌（Mycobacterium tuberculosis.TB)的rpsL基因突变往往与链霉素（Streptomycin.SM)耐药变异有关。选择了77例TB临床分离株,应用BACTEC460快速培养系统进行常规药敏实验,同时针对rpsL基因进行聚合酶链反应（PCR）,对PCR产物进行单链构型多态性（SSCP）分析,MboⅡ酶切后的限制性片段长度分析（RFLP）和序列测定分析。常规药敏实验显示：有20株为SM敏感,57株为耐药。SSCP显示：34株的rpsL基因为野生型,43株为突变型。与常规药敏相比SSCP的特异性与阳性预期值分别为95％和98％。RFLP显示：81.4%的突变类型使其失去MboⅡ酶切位点。序列测定显示：失去MboⅡ酶切位点的突变为rpsL基因43位密码子存有单碱基突变（AAG→AGG）。实验结果表明,TB对SM耐药变异与rpsL基因突变相关,其中第43位密码子的突变是最常见的原因。     

应用膜反向斑点杂交技术快速检测结核分支杆菌耐乙胺丁醇基因型的研究

应用膜反向斑点杂交技术快速检测结核分支杆菌对乙胺丁醇（EMB）耐药性。设计与合成用于检测结核分支杆菌耐EMB基因embB的寡核苷酸探针,点于硝酸纤维素膜上,与结核分支杆菌临床分离株生物素标记的聚合酶链反应（PCR）产物进行反向斑点杂交,并与PCR单链构象多态性（PCRSSCP）和PCR直接测序（PCRDS）结果比较。对81株结核分支杆菌临床分离株进行分析,31株EMB敏感株中,26株embB基因的SSCP图谱、膜反向斑点杂交结果与标准株(H37Rv)完全相同;其余5株SSCP图谱出现泳动变位,其中3株E1b杂交阳性,PCRDS分析为embB基因306位密码子ATG→GTG突变;2株E1d杂交阳性,PCRDS分析为embB基因306位密码子ATG→ATA突变。50株耐EMB菌株中,24株PCRSSCP 图谱与标准菌株相同,E1杂交阳性;26株PCRSSCP图谱出现泳动变位,其中18株E1b杂交阳性,2株E1c杂交阳性,5株E1d杂交阳性,1株E1e杂交阳性,未发现E1f杂交阳性,与PCRSSCP、PCRDS分析结果一致。突变检出率为52%。 膜反向斑点杂交技术可能成为检测部分结核分支杆菌乙胺丁醇耐药基因型简便、快速的方法。     

结核分枝杆菌利福平耐药性的研究进展

本旨在阐明结核分枝杆菌耐利福平分离株rpoB基因突变的规律,以及rpoB基因突变与利福平最低抑菌浓度(MIC)的关系。结核分枝杆菌的rpoB基因突变是引起利福平耐药性的主要原因,耐利福平分离株的rpoB基因突变主要集中在507～533位密码子的81bp的区域内,约80％的菌株发生531位或526位密码子突变。不同类型rpoB基因突变的结核分枝杆菌对利福平的耐受性也不同,通常发生531位密码子突变的菌株的MIC≥64μg／ml。     

结核分枝杆菌耐链霉素和乙胺丁醇分子机制的研究

目的:研究结核分枝杆菌耐链霉素和乙胺丁醇的rpsL和emb B基因突变情况,探讨耐药基因突变与耐药性的关系。方法:通过传统药敏实验和聚合酶链反应(PCR)--单链构象多态性(SSCP)技术初步鉴定62株临床分离株的药敏和rps L、emb B基因。结果:与结核菌标准株H37Rv对照,分析30例TB菌耐链霉素(SM)的rps L基因,发现其突变率为70.0%(21/30),分析29例耐乙胺丁醇(EMB)的emb B基因,该基因的突变率为65.5%(19/29)。结论:部分结核分枝杆菌耐SM和EMB是由于其rps L、emb B基因突变所致,PCR-SSCP银染技术可能成为测定部分结核分枝杆菌耐药的简便、快速的方法。     

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     

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。     

多耐药临床分离株结核分支杆菌耐药基因rpsL 的克隆表达及功能的初步研究

制备多耐药临床分离株结核分支杆菌基因组DNA,PCR扩增其耐药基因rpsL基因和rrS基因,同时进行测序分析,结果显示该株多耐药临床分离株结核分支杆菌的rpsL基因的93、94bp处的碱基发生了突变,碱基C、C突变为T、T,使得相对应的编码氨基酸由脯氨酸(Pro)突变为亮氨酸(Leu);而rrS基因未发生核苷酸的插入、缺失或取代;进一步构建该株多耐药临床分离株结核分支杆菌耐药基因rpsL高效原核表达重组我体pGEX-λ T／rpsL,所构建的重组质粒pGEX-λ T／rpsL在大肠杆菌中高效表达了38kD的融合蛋白．结果提示,该株多耐药临床分离株结核分支杆菌对链霉素耐药仅仅是由于rpsL基因的个别碱基突变,是单基因型的,在国内外属首次研究发现．     

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。     

Detection of Streptomycin Resistance in Mycobacterium tuberculosis Clinical Isolates Using Four Molecular Methods in China

To evaluate the relationship between mutations in rpsL or rrs genes and streptomycin (SM) resistance, we compared four molecular methods for their clinical value in the detection of SM resistance. Genotypic analysis of SM resistance in 167 M. tuberculosis clinical strains isolated from Chinese patients was performed by direct DNA sequencing, SSCP, RFLP, and reverse dot-blot hybridization (RDBH) assays. Of the 98 SM-resistant isolates, 78 (79.6%) had missense mutations in codon 43 or 88 of rpsL resulting in a Lys to Arg substitution, 6 (6.1%) had mutations of the rrs gene at positions 513 A to C or T or 516 C to T, and 14 (14.3%) had the wild-type sequence. None of the 69 SM-susceptible isolates examined had alterations in rpsL or rrs. The results of the SSCP, RFLP, and RDBH analyses for these mutations and wild-type sequences were completely consistent with DNA sequencing data. Five distinct single-nucleotide substitutions in codon 43 or 88 of rpsL gene or in position 513 or 516 of rrs gene were correctly identified in 84 of 98 (85.7%) phenotypically SM-resistant isolates by RDBH assay. Molecular analyses of the rpsL and rrs genes are useful for rapid prediction of SM resistance in most clinical strains of M. tuberculosis. Reverse dot-blot hybridization assay is a rapid, simple, and reliable method for the detection of drug resistance.     

Characterization of the rpsL and rrs genes of streptomycin-resistant clinical isolates of Mycobacterium tuberculosis in Japan

Mutations in the rpsL and rrs genes associated with streptomycin resistance in Mycobacterium tuberculosis clinically isolated in Japan were characterized. The rpsL genes of 172 clinical isolates were amplified by PCR and classified into two groups on the basis of Mbo II restriction digestion. Thirty-three out of 54 (61·1%) streptomycin-highly resistant isolates (MIC > 200 μg ml⁻¹) were not digested by Mbo II. By contrast, the remaining 21 of 54 (38·9%) streptomycin-highly resistant isolates, all of 41 isolates with streptomycin resistance at a lower level (20 μg ml⁻¹ < MIC ≤ 200 μg ml⁻¹), and all of 77 streptomycin-sensitive isolates, were restricted. Thus, all isolates resistant for Mbo II digestion showed a high level of resistance to streptomycin. Subsequently, the sequence for the rpsL and rrs genes from the 46 isolates were analysed. Eighteen out of 19 (94·7%) streptomycin-highly resistant isolates carried a mutation in any rpsL gene at position 43 or 88, or the rrs gene ; 10 out of 17 (58·8%) streptomycin-resistant isolates at a lower level were confirmed to exhibit the mutation of either the mutated rpsL gene at position 88, or the rrs gene. In the total 36 streptomycin-resistant isolates, the mutation of the rpsL or rrs gene was observed in 28 streptomycin-resistant isolates, corresponding to 77·8%, whereas none of the streptomycin-sensitive isolates had mutations in either the rpsL or rrs gene.     

Detection of streptomycin resistance in Mycobacterium tuberculosis clinical isolates from China as determined by denaturing HPLC analysis and DNA sequencing

China is regarded by the World Health Organization as a major hot-spot region for Mycobacterium tuberculosis infection. Streptomycin has been deployed in China for over 50 years and is still widely used for tuberculosis treatment. We have developed a denaturing HPLC (DHPLC) method for detecting various gene mutations conferring drug resistance in M. tuberculosis. The present study focused on rpsL and rrs mutation analysis. Two hundred and fifteen M. tuberculosis clinical isolates (115 proved to be streptomycin-resistant and 100 susceptible by a routine proportional method) from China were tested to determine the streptomycin minimal inhibitory concentration (MIC), and subjected to DHPLC and concurrent DNA sequencing to determine rpsL and rrs mutations. The results showed that 85.2% (98/115) of streptomycin-resistant isolates harbored rpsL or rrs mutation, while rpsL mutation (76.5%, 88/115) dominated. MIC of 98 mutated isolates revealed no close correlation between mutation types and levels of streptomycin resistance. No mutation was found in any of the susceptible isolates. The DHPLC results were completely consistent with those of sequencing. The DHPLC method devised in this study can be regarded as a useful and powerful tool for detection of streptomycin resistance. This is the first report to describe DHPLC analysis of mutations in the rpsL and rrs genes of M. tuberculosis in a large number of clinical isolates.     

Drug resistance-conferring mutations in Mycobacterium tuberculosis from Madang, Papua New Guinea

ABSTRACT: BACKGROUND: Monitoring drug resistance in Mycobacterium tuberculosis is essential to curb the spread of tuberculosis (TB). Unfortunately, drug susceptibility testing is currently not available in Papua New Guinea (PNG) and that impairs TB control in this country. We report for the first time M. tuberculosis mutations associated with resistance to first and second-line anti-TB drugs in Madang, PNG. A molecular cluster analysis was performed to identify M. tuberculosis transmission in that region. RESULTS: Phenotypic drug susceptibility tests showed 15.7% resistance to at least one drug and 5.2% multidrug resistant (MDR) TB. Rifampicin resistant strains had the rpoB mutations D516F, D516Y or S531L; isoniazid resistant strains had the mutations katG S315T or inhA promoter C15T; streptomycin resistant strains had the mutations rpsL K43R, K88Q, K88R), rrs A514C or gidB V77G. The molecular cluster analysis indicated evidence for transmission of resistant strain. CONCLUSIONS: We observed a substantial rate of MDR-TB in the Madang area of PNG associated with mutations in specific genes. A close monitoring of drug resistance is therefore urgently required, particularly in the presence of drug-resistant M. tuberculosis transmission. In the absence of phenotypic drug susceptibility testing in PNG, molecular assays for drug resistance monitoring would be of advantage.     

Multicenter evaluation of reverse line blot assay for detection of drug resistance in Mycobacterium tuberculosis clinical isolates

A multicenter study was conducted with the objective to evaluate a reverse line blot (RLB) assay to detect resistance to rifampin (RIF), isoniazid (INH), streptomycin (STR), and ethambutol (EMB) in clinical isolates of Mycobacterium tuberculosis. Oligonucleotides specific for wild type and mutant (drug resistance linked) alleles of the selected codons in the genes rpoB, inhA, ahpC, rpsL, rrs, embB, were immobilized on a nylon membrane. The RLB assay conditions were optimized following analysis of DNA samples with known sequences of the targeted genes. For validation of the method at different geographical locations, the membranes were sent to seven laboratories in six countries representing the regions with high burdens of multudrug-resistant tuberculosis. The reproducibility of the assay for detection of rpoB genotypes was initially evaluated on a blinded set of twenty reference DNA samples with known allele types and overall concordant results were obtained. Further mutation analysis was performed by each laboratory on the local strains. Upon RLB analysis of 315 clinical isolates from different countries, 132 (85.2%) of 155 RIF-resistant and 28 (51.0%) of 55 EMB-resistant isolates were correctly identified, showing applicability of the assay when targeting the rpoB hot-spot region and embB306. Mutations in the inhA and ahpC promoter regions, conferring resistance to INH, were successfully identified in respectively 16.9% and 13.2% of INH-resistant strains. Likewise, mutations in rrs513 and rpsL88 that confer resistance to STR were identified in respectively 15.1% and 10.7% of STR-resistant strains. It should be mentioned that mutation analysis of the above targets usually requires rather costly DNA sequencing to which the proposed RLB assay presents rapid and inexpensive alternative. Furthermore, the proposed method requires the same simple equipment as that used for spoligotyping and permits simultaneous analysis of up to 40 samples. This technique is a first attempt to combine different targets in a single assay for prediction of antituberculosis drugs resistance. It is open to further development as it allows easy incorporation of new probes for detection of mutations in other genes associated with resistance to second-line (e.g., fluoroquinolones) and new antituberculosis compounds.     

Antimicrobial susceptibility determined by the E test, Löwenstein-Jensen proportion, and DNA sequencing methods among Mycobacterium tuberculosis isolates discrepancies, preliminary results

Mycobacterium tuberculosis strains resistant to streptomycin (SM), isoniazid (INH), and/or rifampin (RIF) as determined by the conventional L?wenstein-Jensen proportion method (LJPM) were compared with the E test, a minimum inhibitory concentration susceptibility method. Discrepant isolates were further evaluated by BACTEC and by DNA sequence analyses for mutations in genes most often associated with resistance to these drugs (rpsL, katG, inhA, and rpoB). Preliminary discordant E test results were seen in 75% of isolates resistant to SM and in 11% to INH. Discordance improved for these two drugs (63%) for SM and none for INH when isolates were re-tested but worsened for RIF (30%). Despite good agreement between phenotypic results and sequencing analyses, wild type profiles were detected on resistant strains mainly for SM and INH. It should be aware that susceptible isolates according to molecular methods might contain other mechanisms of resistance. Although reproducibility of the LJPM susceptibility method has been established, variable E test results for some M. tuberculosis isolates poses questions regarding its reproducibility particularly the impact of E test performance which may vary among laboratories despite adherence to recommended protocols. Further studies must be done to enlarge the evaluated samples and looked possible mutations outside of the hot spot sequenced gene among discrepant strains.     

Effect of valine and the herbicide sulfometuron methyl on acetolactate synthase activity in nuclear and plasmid-borne sulphometuron methyl resistant Saccharomyces cerevisiae strains

Acetolactate synthase (ALS) specific activity was evaluated in isogenic lines of Saccharomyces cerevisiae carrying the wild-type ILV2 gene or mutations in this gene for resistance to the herbicide sulfometuron methyl (SM). Statistical comparisons were made between two nuclear alleles and among five alleles borne on a YE chimaeric plasmid transformed into a strain carrying a 1.5-kilobase deletion in the nuclear ILV2 gene. Decreased ALS activity of plasmid-borne SM-resistant mutations was shown not to be caused by copy number effects. ALS-specific activity in strains carrying the wild-type ILV2 allele exhibited strong feedback inhibition by valine and was sensitive to SM. All nuclear and plasmid-borne SM-resistance alleles resulted in ALS-specific activity highly resistant to SM and resistant to valine feedback inhibition.     

Cloning and sequence analysis of the rpsL and rpsG genes of Mycobacterium smegmatis and characterization of mutations causing resistance to streptomycin.

The Mycobacterium smegmatis rpsL and rpsG genes, encoding the ribosomal proteins S12 and S7, were cloned, and their DNA sequence was determined. The third nucleotide of the S12 termination codon overlapped the first nucleotide of the S7 translation initiation codon. A collection of 28 spontaneous streptomycin-resistant mutants of M. smegmatis were isolated. All had single-base-pair substitutions in the rpsL gene which were changed to a streptomycin-sensitive phenotype by complementation with a low-copy-number plasmid carrying the wild-type M. smegmatis rpsL gene. A total of eight different mutations were found in two specific regions of the rpsL gene. Fifty-seven percent (16 of 28) altered the Lys codon at position 43. Forty-six percent of the mutations (13 of 28) were due to a transition changing an AAG Lys codon to an AGG Arg codon, with eight changes at codon 43 and five at codon 88.     

Prevalence of mutations at codon 463 of katG gene in MDR and XDR clinical isolates of Mycobacterium tuberculosis in Belarus and application of the method in rapid diagnosis

Isoniazid (INH) is a central component of drug regimens used worldwide to treat tuberculosis. In respect to high GC content of Mycobacterium tuberculosis, nonsynonymous mutations are dominant in this group. In this study a collection of 145 M. tuberculosis isolates was used to evaluate the conferring mutations in nucleotide 1388 of katG gene (KatG463) in resistance to isoniazid. A PCR-RFLP method was applied in comparison with DNA sequencing and anti-mycobacterial susceptibility testing. From all studied patients, 98 (67.6%) were men, 47 (32.4%) were women, 3% were <15 and 9% were >65 years old; male to female ratio was 1:2.4. PCR result of katG for a 620-bp amplicon was successful for all purified M. tuberculosis isolates and there was no positive M. tuberculosis culture with PCR negative results (100% specificity). Subsequent PCR RFLP of the katG identified mutation at KatG463 in 33.3%, 57.8% and 59.2% of our clinically susceptible, multidrug resistant TB (MDR) and extensively drug resistant (XDR) isolates, respectively. Strains of H37Rv and Academic had no any mutations in this codon. M. bovis was used as a positive control for mutation in KatG463. Automated DNA sequencing of the katG amplicon from randomly selected INH-susceptible and resistant isolates verified 100% sequence accuracy of the point mutations detected by PCR-RFLP. We concluded that codon 463 was a polymorphic site that is associated to INH resistance (a missense or "quiet" mutation). RFLP results of katG amplicons were identical to those of sequence method. Our PCR-RFLP method has a potential application for rapid diagnosis of M. tuberculosis with a high specificity.