中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2009年
3期
223-226
,共4页
林辉%刘洁%陈林%靖宽和%沈静%詹建%李亚斐%许汝福%熊鸿燕%曹佳
林輝%劉潔%陳林%靖寬和%瀋靜%詹建%李亞斐%許汝福%熊鴻燕%曹佳
림휘%류길%진림%정관화%침정%첨건%리아비%허여복%웅홍연%조가
分支杆菌,结核%乙胺丁醇%基因,embB%抗药性
分支桿菌,結覈%乙胺丁醇%基因,embB%抗藥性
분지간균,결핵%을알정순%기인,embB%항약성
Mycobacterium tuberculosis%Ethambutol%Gene,embB%Drug resistance
目的 了解重庆结核杆菌的embB306突变特征,评价其作为诊断乙胺丁醇(ethambutol,EMB)耐药结核杆菌分子标记物的临床应用价值.方法 采用DNA测序方法分析重庆市结核患者痰中分离的51株EMB耐药结核杆菌和50株EMB敏感株的embB基因突变特征,与传统药敏实验进行诊断学试验评价embB306突变作为EMB耐药株分子标记物的临床应用价值.结果 embB306突变率在51株EMB耐药和50株敏感结核杆菌中分别为75.5%、6%;其中来自复治病例的EMB耐药菌株的embB306突变率是87.5%,高于来自初治病例的48.1%;embB306突变率随菌株耐药数量增加而升高,embB306在EMB耐药的耐多药菌株(Multidrug-Resistant Tuberculosis,MDR-TB)中的突变率高于EMB耐药的非MDR-TB和EMB敏感的MDR-TB的突变率;以embB306突变诊断EMB耐药菌株的诊断学试验评价主要指标为:灵敏度为66.7%;特异度为94.0%;准确度为80.2%;Youden指数为60.7%.结论embB306突变是重庆地区结核杆菌产生EMB耐药性的主要分子机制,且与耐药数量和治疗时间有关,其作为EMB耐药菌株诊断的分子标记物具有一定临床应用价值.
目的 瞭解重慶結覈桿菌的embB306突變特徵,評價其作為診斷乙胺丁醇(ethambutol,EMB)耐藥結覈桿菌分子標記物的臨床應用價值.方法 採用DNA測序方法分析重慶市結覈患者痰中分離的51株EMB耐藥結覈桿菌和50株EMB敏感株的embB基因突變特徵,與傳統藥敏實驗進行診斷學試驗評價embB306突變作為EMB耐藥株分子標記物的臨床應用價值.結果 embB306突變率在51株EMB耐藥和50株敏感結覈桿菌中分彆為75.5%、6%;其中來自複治病例的EMB耐藥菌株的embB306突變率是87.5%,高于來自初治病例的48.1%;embB306突變率隨菌株耐藥數量增加而升高,embB306在EMB耐藥的耐多藥菌株(Multidrug-Resistant Tuberculosis,MDR-TB)中的突變率高于EMB耐藥的非MDR-TB和EMB敏感的MDR-TB的突變率;以embB306突變診斷EMB耐藥菌株的診斷學試驗評價主要指標為:靈敏度為66.7%;特異度為94.0%;準確度為80.2%;Youden指數為60.7%.結論embB306突變是重慶地區結覈桿菌產生EMB耐藥性的主要分子機製,且與耐藥數量和治療時間有關,其作為EMB耐藥菌株診斷的分子標記物具有一定臨床應用價值.
목적 료해중경결핵간균적embB306돌변특정,평개기작위진단을알정순(ethambutol,EMB)내약결핵간균분자표기물적림상응용개치.방법 채용DNA측서방법분석중경시결핵환자담중분리적51주EMB내약결핵간균화50주EMB민감주적embB기인돌변특정,여전통약민실험진행진단학시험평개embB306돌변작위EMB내약주분자표기물적림상응용개치.결과 embB306돌변솔재51주EMB내약화50주민감결핵간균중분별위75.5%、6%;기중래자복치병례적EMB내약균주적embB306돌변솔시87.5%,고우래자초치병례적48.1%;embB306돌변솔수균주내약수량증가이승고,embB306재EMB내약적내다약균주(Multidrug-Resistant Tuberculosis,MDR-TB)중적돌변솔고우EMB내약적비MDR-TB화EMB민감적MDR-TB적돌변솔;이embB306돌변진단EMB내약균주적진단학시험평개주요지표위:령민도위66.7%;특이도위94.0%;준학도위80.2%;Youden지수위60.7%.결론embB306돌변시중경지구결핵간균산생EMB내약성적주요분자궤제,차여내약수량화치료시간유관,기작위EMB내약균주진단적분자표기물구유일정림상응용개치.
Objective To understand the characteristics of embB gene mutation of Mycobacterium tuberculosis (MTB) isolates from tuberculosis patients in Choagqing, and the value of embB306 as a molecular marker used to diagnose ethambutol (EMB)-resistant MTB strains. Methods Direct sequencing was used to analyze the polymorphism of embB mutation in 51 EMB-resistant MTB strains and 50 EMB-sensitive MTB strains. And diagnostic testing was used to evaluate the value of embB306 as a molecular marker of EMB -resistant MTB strains as compared with the traditional sensitivity test. Results All 34 of 51 EMB-resistant strains (66.7%) and 3 of 51 EMB- sensitive strains (6%) had had embB306 mutation. The embB306 mutation rate in EMB-resistant strains coming from previously treated case was 87.5%, showing significantly higher than that from new cases (48.1% ,P<0.01); embB306 mutation rate was increased with the number of the resistant drugs; embB306 mutation serving as a marker to diagnose EMB-resistant MTB strains comparing with the traditional sensitivity test,had the rate of sensitivity = 66.7% ,specificity =94.0% ,accuracy = 80.2% and Youden index = 60.7%. Conclusion embB306 mutation should be the main mechanism of MTB resistance to EMB in Chongqing, showing an association with the history of the treated and numbers of the resistant drugs, embB306 mutation should be a good marker to diagnose EMB-resistant MTB strains.
