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中华临床实验室管理电子杂志

中华临床实验室管理电子杂志 ›› 2020, Vol. 08 ›› Issue (02) : 65 -70. doi: 10.3877/cma.j.issn.2095-5820.2020.02.001

所属专题： 文献；

综述

结核分枝杆菌耐多药基因及其检测新技术
朱庆义1,†()   
  1. 1. 030032　太原，太原金域临床检验所
  • 收稿日期:2019-10-28 出版日期:2020-05-28
  • 通信作者: 朱庆义

Multidrug-resistant genes of mycobacterium tuberculosis and associated detection methods

Qingyi Zhu1,†()   

  1. 1. Taiyuan Kingmed Center for Clinical Laboratory, Taiyuan 030032, China
  • Received:2019-10-28 Published:2020-05-28
  • Corresponding author: Qingyi Zhu
  • About author:
    Corresponding author: Zhu Qingyi, Email:
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朱庆义. 结核分枝杆菌耐多药基因及其检测新技术[J]. 中华临床实验室管理电子杂志, 2020, 08(02): 65-70.

Qingyi Zhu. Multidrug-resistant genes of mycobacterium tuberculosis and associated detection methods[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2020, 08(02): 65-70.

结核病曾严重地威胁着人类的健康，随着抗结核药物的不断发展和人们卫生状况的改善，结核病的发病率和病死率大幅度下降。但20世纪80年代后,由于结核分枝杆菌耐药性和耐多药菌株的产生，肺结核的发病率又有所提升。本文针对耐多药结核病人的病原学快速诊断及其耐药基因的类型、耐药机理和分子生物学诊断新技术作了简述。

关键词: 结核分枝杆菌, 耐多药基因, 分子生物学诊断

Tuberculosis (TB) has been a serious threat to human health. With the continuous development of anti-TB drugs and the improvement of people’s health conditions, the incidence and mortality of TB has been greatly reduced. However, after the 1980s, the incidence of TB increased due to the emergence of drug-resistant strains and multidrug resistance of mycobacterium tuberculosis (MTB). In this paper, we review the rapid diagnosis etiology of multidrug resistant tuberculosis (MDR-TB), the types of drug-resistant genes, the mechanism of drug resistance and the new diagnostic techniques based on molecular biology .

Key words: Mycobacterium tuberculosis, Multidrug resistant genes, Molecular biological diagnosis
表1 MTB与获得性耐药相关的主要基因
药物(Drug) 基因(Gene) 产物(Product)
第一线药(firstline)
? 异烟肼(isoniazid) katG 过氧化氢酶-过氧化物酶-过氧亚硝基酶T
? inhA 烟酰胺腺嘌呤二核苷酸-依赖性烯酰酰基载体蛋白还原酶
? ndh 烟酰胺腺嘌呤二核苷酸脱氢酶
? ahpC 烷基过氧化氢还原酶C
? 利福平(rifampin) rpoB DNA导向RNA聚合酶β
? 吡嗪酰胺(pyrazinamide) pncA 吡嗪酰胺酶/烟酰胺酶
? 乙胺丁醇(ethambutol) embCAB 膜吲哚乙酰肌醇阿拉伯糖基转移酶
? 链霉素(streptomycin) rpsL 30S核糖体蛋白S12
? rrs 16S rRNA
? gidB 葡萄糖抑制有丝分裂蛋白B
第二线药(Second line)
? 阿米卡星-卡那霉素(amikacin-kanamycin) rrs 16S rRNA
? eis 增强细胞内生存蛋白
? 乙硫异烟胺(ethionamide) ethA 单氧酶
? inhA NADH-依赖性烯酰酰基载体蛋白还原酶
? ethR TetR家族转录抑制因子
? ndh NADH脱氢酶
? 氟喹诺酮(fluoroquinolones) gyrAB DNA旋转酶
? 对氨基水杨酸(para-amino-salicylic acid) thyA 胸苷酸合成酶
? folC 聚谷氨酸合成酶C
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