在Mycobacterium结核病中,c-54t补偿基因突变并不总是对异化物耐药性的有效替代品
Viktória Szél1, Jody E Phelan2, Sophia B Georghiou3
1National Reference Laboratory for Mycobacteriology, National Koranyi Institute of Pulmonology, Budapest, Hungary.
Antimicrobial agents and chemotherapy
|April 22, 2025
概括
针对Mycobacterium结核病异能酶耐药性的商业测试可能会出现错误. 依靠补偿突变而不是抗性突变,可能导致假抗性结果和冲击治疗.
科学领域:
- 分子诊断学 分子诊断学
- 抗微生物耐药性 抗微生物耐药性
- 结核病的研究研究.
背景情况:
- 商业基因型抗微生物敏感性测定被广泛用于Mycobacterium结核病.
- 这些测试经常检测ahpC上游的突变,以推断异化物耐药性.
- 基因参与异化耐药性,katG中的突变是主要的驱动因素.
研究的目的:
- 评估商业基因型测试的准确性,以推断Mycobacterium tuberculosis中的异化物耐药性.
- 调查依赖补偿突变与致病性抗性突变的影响.
主要方法:
- 分析了13个商业基因型抗微生物敏感性测定.
- 专注于ahpC c-54t突变作为异化物耐药性的标志物.
- 与katG基因中因果性耐药性突变的比较.
主要成果:
- 依赖ahpC c-54t补偿突变可以导致对异化的系统性假耐药结果.
- 这在Cepheid Xpert MTB/XDR测定中尤其如此.
- 这种不准确的结果可能导致患者的治疗不够理想.
结论:
- 目前的基因型检测可能会错误诊断异化物耐药性,因为它依赖于补偿突变.
- 世界卫生组织 (WHO) 的突变目录需要改进,以解决这一具体情况.
- 准确的基因型解释对于有效的Mycobacterium结核病治疗至关重要.
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