Correlation of diabetes with mutation of rpoB gene resistance site of Mycobacterium tuberculosis
Objective To understand the molecular characteristics of rifampicin rpoB gene mutation site in patients with rifampin-resistant pulmonary tuberculosis(RR-TB)complicated with diabetes mellitus,and to explore whether the combination of diabetes mellitus affects rifampicin resistance-related gene mutation,providing data support for prevention and treatment of tuberculosis complicated with diabetes comorbidity.Methods A total of 170 patients with rifampicin-resistant pulmonary tuberculosis diagnosed by mycobacterium culture in sputum or alveolar lavage fluid and drug sensitivity test at the Second Affiliated Hospital of Hainan Medical University from 2022 to 2023 were selected.According to whether they were comorbid with diabetes,patients were divided into two groups:rifampicin-resistant tuberculosis without diabetes group(RR-TB;n=102)and rifampicin-resistant tuberculosis with diabetes group(RR-TB+DM;n=68).Rifampicin rpoB gene loci were detected in sputum or alveolar lavage fluid samples from all patients by microarray method,and the mutation characteristics of rifampicin resistance loci in the two groups were analyzed to explore the differences of drug resistance loci.Results The proportion of rifampicin resistance was higher in males,retreatment,smear positive and 40 to<60years old,but there was no statistically significant difference between the two groups(P>0.05);the proportion of patients aged 20 to<40 years in RR-TB+DM group(11.8%,8/68)was significantly lower than that in the RR-TB+DM group(24.5%,25/102)(χ2=4.237,P<0.05);the main mutation sites of the rpoB gene in both groups were 531,526 and 511,but the mutation frequency of the sites was slightly different.The most common mutation sites in RR-TB+DM group were 531(57.4%,39/68),526(19.1%,13/68),and 511(8.9%,6/68),whereas in the RR-TB group,they were 531(51.9%,53/102),526(18.6%,19/102),and 511(14.8%,15/102),but there was no significant difference between the two groups(P>0.05).The mutation of 531 was mainly TCG→TTG.The 526 had four mutation types,with CAC→TAC being the main mutation type.The main mutation type of 526 in the RR-TB group was CAC→GAC,while there was no CAC→GAC mutation at 526 in the RR-TB+DM group,and the difference between the two groups was statistically significant(P<0.05).The 511 mutation was mainly CTG→CCG,but there was no significant difference between the two groups(P>0.05).Conclusions The mutation rate of RpoB 526CAC→GAC and the proportion of rifampin resistance in patients aged 20 to<40 years are significantly lower in pulmonary tuberculosis with diabetes than in simple pulmonary tuberculosis,suggesting that diabetes may affect the gene mutation at this site.
Drug-resistant tuberculosisdiabetes mellitusrifampinrpoBmutation site
万方数据
维普
