艾滋病患者合并感染的分枝杆菌的菌种构成与分子特征分析

发布时间：2018-08-24 07:21

【摘要】：目的获得HIV/AIDS患者合并感染的分枝杆菌的菌种和构成比。检测HIV/AIDS患者合并感染的结核杆菌耐药基因突变率,并对结核分枝杆菌进行毒力的分析。方法通过分枝杆菌通用引物对细菌DNA保守序列hsp65进行PCR扩增并进行测序；使用巢式PCR对HIV/AIDS患者结核菌inhA、rpoB、katG、embB、rpsL、rrs和pncA这7个一线抗结核药物相关耐药基因进行扩增并进行测序,检测相关耐药基因突变率；通过RD105(regions of difference105)缺失鉴定技术来分析结核菌株中“北京型”的比例,由此来进行结核分枝杆菌感染毒力的分析。结果326例HIV/AIDS患者分离出的分枝杆菌DNA标本中有阳性结果标本数为244例,阴性结果标本数为82例。阳性结果中结核杆菌167株,占68.4%；非结核分枝杆菌77株,占31.6%。非结核分枝杆菌包括戈登分枝杆菌39株,鸟-胞内分枝杆菌复合群18株,堪萨斯分枝杆菌12株,脓肿分枝杆菌3株,偶遇分枝杆菌2株,马赛分枝杆菌2株,蟾分枝杆菌1株。除inhA无突变以外,其余6个基因均有突变,rpoB、katG、embB、rpsL、rrs和pncA这6个基因的突变率分别为11.9%、7.7%、3.8%、12.7%、4.8%、6.1%。82株HIV/AIDS患者合并感染的结核杆菌中,“北京型”63株,占76.8%；“非北京型”19株,占23.1%。结论分枝杆菌感染是HIV/AIDS患者常见的并发症之一,其中结核分枝杆菌、鸟-胞内分枝杆菌复合群和堪萨斯分枝杆菌又为HIV/AIDS患者分枝杆菌感染并发症中最常见的四种菌种。HIV/AIDS患者结核菌的rpoB、katG、embB、rpsL、rrs和pncA这6个基因存在不同的突变率。“北京型”菌株是结核杆菌中的毒力较强菌株,而艾滋病患者分离出的结核杆菌中“北京型”占大多数。
[Abstract]:Objective to obtain the species and composition of Mycobacterium coinfection in patients with HIV/AIDS. The mutation rate of drug resistance gene of Mycobacterium tuberculosis co-infected with HIV/AIDS was detected and the virulence of Mycobacterium tuberculosis was analyzed. Methods the conserved sequence of DNA hsp65 was amplified by PCR and sequenced by universal primers of Mycobacterium, and inhA,rpoB,katG,embB,rpsL,rrs and pncA of HIV/AIDS patients were amplified and sequenced by nested PCR. To detect the mutation rate of drug-resistant genes and to analyze the proportion of "Beijing type" in tuberculous strains by RD105 (regions of difference105 deletion identification technique, and then to analyze the virulence of Mycobacterium tuberculosis infection. Results the positive and negative results of Mycobacterium DNA specimens isolated from 326 patients with HIV/AIDS were 244 and 82 respectively. The positive results included 167 strains of Mycobacterium tuberculosis (68.4%) and 77 strains of non-tuberculous mycobacterium (31.6%). Non-tuberculosis Mycobacterium included 39 strains of Mycobacterium Gordon, 18 strains of bird-intracellular mycobacterium complex, 12 strains of Mycobacterium Kansas, 3 strains of mycobacterium abscess, 2 strains of mycobacterium incidentally, 2 strains of Mycobacterium Marseilles and 1 strain of Xenopus. With the exception of no mutation in inhA, the mutation rates of the other six genes, rpoBnkatGlub, rpsLrrs and pncA, were 11.9and 7.7and 3.87.7and 3.86.1.82 strains of Mycobacterium tuberculosis co-infected with HIV/AIDS, respectively, of which 63 strains were "Beijing type", accounting for 76.8b; 19 strains were non-Beijing type, accounting for 23.1T. Conclusion Mycobacterium infection is one of the common complications in patients with HIV/AIDS. Mycobacterium complex and Mycobacterium Kansas are the four most common strains of Mycobacterium infection complications in HIV/AIDS patients. The rpoB,katG,embB,rpsL,rrs and pncA genes of HIV / AIDS patients have different mutation rates. Beijing type is one of the most virulent strains of Mycobacterium tuberculosis, and the most of the strains isolated from AIDS patients are Beijing type.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.91

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