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中国防痨杂志 ›› 2014, Vol. 36 ›› Issue (5): 350-355.doi: 10.3969/j.issn.1000-6621.2014.05.011

• 论著 • 上一篇    下一篇

单耐氧氟沙星的结核分枝杆菌耐药机制研究

王前 宋媛媛 池俊英 王玉峰 赵雁林   

  1. 102206  北京,中国疾病预防控制中心结核病预防控制中心办公室(王前),参比实验室(宋媛媛、王玉峰、赵雁林);中华人民共和国国家卫生和计划生育委员会与比尔及梅琳达·盖茨基金会结核病防治项目办公室(池俊英)
  • 收稿日期:2013-10-30 出版日期:2014-05-10 发布日期:2014-06-07
  • 通信作者: 池俊英;赵雁林 E-mail:chijunying@chinatb.org;zhaoyanlin@chinatb.org
  • 基金资助:

    中国卫生部-比尔及梅琳达·盖茨基金会结核病防治项目(2009-04-01)

Study on the mechanism of drug resistance in mono ofloxacin-resistant Mycobacterium tuberculosis

WANG Qian,SONG Yuan-yuan,CHI Jun-ying,WANG Yu-feng,ZHAO Yan-lin   

  1. National Center for TB Control and Prevention,China CDC,Beijing  102206, China
  • Received:2013-10-30 Online:2014-05-10 Published:2014-06-07
  • Contact: CHI Jun-ying;ZHAO Yan-lin E-mail:chijunying@chinatb.org;zhaoyanlin@chinatb.org

摘要: 目的 探讨单耐氧氟沙星的结核分枝杆菌中耐药相关基因突变及外排泵基因PstB两种不同耐药机制的作用。 方法 从国家结核病参比实验室2007年全国耐药基线调查菌株库中挑选单耐氧氟沙星的菌株17株。采用直接测序法检测利福平耐药相关基因gyrAgyrB突变情况。提取gyrAgyrB无突变菌株的RNA后反转录并采用Real-time PCR方法检测20个药物外排泵基因的表达量,对比菌株最低抑菌浓度(MIC)试验结果,筛选可能与氧氟沙星药物外排泵的相关基因,并选用大肠埃希菌为模式生物构建表达载体,检测过表达目的外排泵蛋白的大肠埃希菌对氧氟沙星的耐药程度加以验证。 结果  在17株单耐氧氟沙星的菌株中,有4株(4/17)检测到gyrA突变,其中包括90位点突变1株及94位点突变3株,上述突变均表现为高浓度耐药,其MIC均不低于4μg/ml。在gyrAgyrB未突变菌株中,通过real-time PCR检测发现在高浓度耐药的2株菌株中,Rv0933和Rv2938的转录水平显著高于其他低浓度耐药菌株,较对照株H37Rv转录水平高16倍和5倍。在对照组和转入pEASY-E1-Rv2938的大肠埃希菌中MIC均小于0.125μg/ml,而转入pEASY-E1-Rv0933的大肠埃希菌的MIC为2μg/ml。 结论  本研究结果显示,gyrA耐药决定区基因突变与氧氟沙星高浓度耐药相关,PstB可能是氧氟沙星特异性的药物外排泵基因,其高水平表达与氧氟沙星高浓度耐药相关。

关键词: 分枝杆菌, 结核, 荧光喹诺酮类, 抗药性, 细菌, DNA促旋酶

Abstract: Objective  To investigate the function of the genes related with drug resistance and efflux pump in mono ofloxacin (Ofx)-resistant M. tuberculosis (Mtb) isolates. Methods  Seventeen mono Ofx-resistant Mtb clinical isolates were obtained from National Tuberculosis Reference Laboratory. Direct sequencing was performed to detect the mutations in the gyrA/B genes. The total RNA was extracted from the Ofx-resistant strains without gyrA/B mutations. After RNA reverse transcription, the expression levels of 20 drug efflux genes were detected by Real-time PCR. In comparison with the corresponding MIC results, the Ofx-related efflux pumps were screened from 20 drug efflux genes, and the function of candidates was identified among transgenic E.coli. Results  Of 17 mono Ofx-resistant strains, 4 (4/17) strains were found the mutations of gyrA, in which 1 isolates had mutation at codon 90 and 3 isolate had mutation at codon 94. In addition, the isolates harboring gyrA mutation displayed high-level of drug resistance, their MICs were more than 4 μg/ml. Among the strains without gyrA/B mutations, the expression levels of Rv0933 and Rv2938 were higher in 2 high-level resistant strains, which was 16 and 5 folds higher than that of H37Rv strain, respectively. Furthermore, E.coli BL21 transferred with pEASY-E1-Rv0933 showed higher MIC level, 2μg/ml, compared with the control E.coli. Conclusion  The mutations in gyrA are associated with high-level of Ofx resistance. Rv0933 may be the Ofx-specific efflux pumps in Mycobacterium tuberculosis. The high level of Rv0933 expression may correlated with high-level of Ofx resistance.

Key words: Mycobacterium tuberculosis, Fluoroquinolones, Drug resistance, bacterial, DNA Gyrase