【摘要】 目的 探讨北京地区结核分枝杆菌卷曲霉素(Cm)和阿米卡星(Am)耐药与rrs基因和tlyA基因突变相关性。方法 采用比例法对保存的临床菌株进行Cm和Am药敏试验测定,并对其中的临床菌株rrs基因和tlyA基因进行PCR、测序分析。筛选得到了10株Am耐药菌株、25株Cm耐药菌株、15株Am和Cm交叉耐药菌株,并选择了30株敏感菌株作为对照分析。数据采用SPSS 17.0进行统计分析,组间率的比较采用Fisher精确概率法检验,P<0.05为差异有统计学意义。结果 tlyA基因突变结果显示,Cm耐药菌株有6株突变(24.0%,6/25),与敏感菌株相比差异有统计学意义(P<0.05),Am耐药菌株、Am和Cm交叉耐药菌株与敏感菌株相比差异无统计学意义(P>0.05);在rrs基因检测中,Am耐药、Cm耐药、Am和Cm交叉耐药突变率分别有30.0%(3/10)、8.0%(2/25)和26.7%(4/15),敏感菌株中也有10.O%(3/30)突变株,3组耐药菌株与敏感菌株比较,差异均无统计学意义(F=2.353、0.06、1.161,P值均>0.05)。在3组中,rrs基因A1401G突变位点突变比例分别是10.0%(1/10)、8.0%(2/25)和13.3%(2/15),1株在Am和Cm交叉耐药双位点突变,共计6株A1401G位点突变菌株,与敏感菌株比较无统计学意义(P>O.05)。另一突变位点C1402T在.Am、Am和Cm交叉耐药中各1株。结论 结核分枝杆菌ayA基因可能与Cm耐药相关,与Am耐药不相关;rrs基因A1401G和C1402T突变可能与Am和Cm交叉耐药有关。更多还原

【Abstract】 Objective To explore the Mycobacterium tuberculosis of rrs and tlyA genes mutations associated with capreomycin and amikacin resistance in Beijing.Methods The preservation of clinical strains were idenfitied capreomycin and amikacin susceptibility by proportion method,and were performed to identify clinical strains of rrs and tlyA mutations by PCR and sequencing analysis.There were 10 cases of amikacin resistant strains,25 cases of capreomycin resistant strains,15 cases of amikacin and capreomycin cross resistant strains,and 30 cases of sensitive strains were as the contrast analysis.SPSS 17.0 is used for data statistical analysis,group rate is compared with the Fisher exact probability test,P<0.05 is considered statistically significant difference.Results The results of tlyA gene mutations showed that six mutant strains(24%,6/25) had drug resistant strains of capreomycin,compared with the sensitive strain was statistically significant(P<0.05),Am,Am and Cm cross resistance strains compared with susceptible strains had no statistical significance(P>0.05) s Am,Cm,Am and Cm cross resistance of mutations rate were respectively 30.0%(3/10),30.0%(2/25),26.7%(4/15) in rrs gene,sensitive strains of mutations rate was 10.0%(3/30),three groups of drug resistant strains and sensitive strains were not statistically significant difference(F=2.353,0.06、1.161,P>0.05).In three groups,the A1401 G of rrs gene mutations rate were respectively 10.0%(1/10),8.0%(2/25),13.3%(2/15),one strain was double mutations site in the Am and Cm cross resistance group,6 strains were A1401 G mutation strains,compared with the sensitive strain had no statistical significance(P>0.05).The C1402 T of rrs gene mutations had respectively one stains in the Am,Am and Cm cross resistance groups.Conclusion Mutations of tlyA gene may be associated with capreomycin resistance,and was not relevant to amikacin resistance;Mutations of rrs gene A1401 G and C1402 T could be related to amikacin and capreomycin cross resistance in Mycobacterium tuberculosis strains.更多还原