摘要
目的:评估检测pncA、rpsA和panD基因突变用于预测吡嗪酰胺(PZA)耐药性的效能。方法:使用MIGT 960对152株耐多药(MDR)结核分枝杆菌菌株进行PZA药敏性测定。通过测序鉴定pncA、rpsA及panD的基因突变情况,并与标准菌株H37Rv的序列进行比较。分析PZA耐药表型与基因突变的相关关系。结果:152株MDR结核分枝杆菌菌株中,105株为PZA耐药菌株,102株的pncA基因发生了突变。133株菌PZA药敏结果和pncA测序结果一致。8株PZA敏感的菌株发生了pncA基因的突变,其中5株表现为PZA低水平耐药。在11株未发生pncA突变的PZA耐药菌株中,2株的rpsA基因发生了突变,1株的panD基因发生突变。以PZA药敏结果为参照,检测pncA单个基因突变预测PZA耐药的灵敏度为89.52%,特异度为89.36%。当结合检测rpsA和panD基因突变后,可使灵敏度增加到92.38%。结论:检测pncA、rpsA和panD基因突变有利于MDR结核分枝杆菌菌株PZA耐药的及时诊断。
Aim:To evaluate the performance of pncA,rpsA and panD mutations for predicting pyrazinamide(PZA)resistance of mutiple-drug resistant(MDR)tuberculosis.Methods:A total of 152 MDR clinical isolates were included in this study.PZA susceptibility test was analyzed for all the isolates using the MIGT 960.The mutations of pncA,rpsA and panD were determined by sequencing and compared with the sequence of standard strain H37Rv.The correlation between PZA resistant phenotype and genotype was analyzed.Results:Among these 152 MDR tuberculosis isolates,105 showed phenotypically PZA resistant,and 102 had mutations in the pncA gene.A total of 133 isolates mutation pattens were consistent with the mutation of pncA gene.Eight PZA sensitive isolates had the pncA gene mutation,among them,5 isolates showed low level resistance to PZA.Out of the 11 PZA-resistant isolates without pncA mutations,2 isolates had mutation in the rpsA gene,and 1 isolate had mutation in the panD gene.Referred to the PZA drug sensitivity results,the mutation detection of pncA alone had 89.52%sensitivity and 89.36%specificity,respectively.The combination with rpsA and panD mutations increased the sensitivity up to 92.38%.Conclusion:The detection of mutations in pncA,rpsA and panD is beneficial to the timely diagnosis of PZA resistance of MDR tuberculosis.
作者
赵东阳
石洁
苏茹月
郑丹薇
朱岩昆
马晓光
王少华
李辉
孙国清
孙定勇
ZHAO Dongyang;SHI Jie;SU Ruyue;ZHENG Danwei;ZHU Yankun;MA Xiaoguang;WANG Shaohua;LI Hui;SUN Guoqing;SUN Dingyong(Henan Province Center for Disease Control and Prevention,Zhengzhou 450016)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2021年第3期404-408,共5页
Journal of Zhengzhou University(Medical Sciences)
基金
河南省卫健委省部共建项目(SBGJ202002013)。
