結核菌群遺伝子の臨床検査の進歩 - eiken.co.jp

1 194 59 7 2013 . 21.. Satoshi MITARAI.. 4 . 40% 80% . Poly- merase Chain Reaction PCR . 5, 6 . PCR .. 2 . 1, 2 . / .. 1 .. Real- time PCR Transcription-Reverse Transcription Concerted reaction TRC .. 1 .. 7 9 . 50 70% . 1 . 3 . 3 . 3 .. 1ml 10,000 . Gene xpert Cepheid, USA . TB-LAMP Gene xpert Professor/Head, Department of Mycobacterium Reference and Research, 0204 - 8533 3 - 1 - 24 Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (JATA). (3-1-24, Matsuyama, Kiyose-shi, Tokyo). 12 . 195. 1 .. DNA Hybridization protection assay HPA . TMA 5 . FR - MTB . TaqMan probe TaqMan MTB Real -time PCR 3 .. INAF probe TRC Rapid M. TB TRC , M. avium complex, . M. kansasii QProbe . GENECUBE PCR 50 . , M. avium complex . Loopamp LAMP 50 .. 16S rRNA . xpert MTB/Rif . 2 99% . RFP . rpoB Real-time PCR/Molecular.

2 12 . Beacon .. 98% 95%CI, 97-99 .. 68% 95%CI, 59-75 RFP SPEED-OLIGO MYCOBACT- 94% 95%CI, 87-97 ERIA Vircell, Spain PCR . 10 . 98% 95% CI, 97-99 5 . 13 . 19 . 11 . GenoType TB-LAMP PURE Procedure for Ultra Mycobacterium CM/AS Hain Lifescience, Germany . Rapid Extraction, 31 . 14 . 5 .. 1 Isothermal .. 9 .. M. tuberculosis M. bovis M. africanum M. canetti .. M. caprae M. microti M. pinipedii .. M. tuberculosis BCG . 15 .. DNA-DNA hybridization . DDH , .. mg .. 13 . 196. Resistance Determining Region, 81bp . RFP. 1 2 6 95% . 16 . rpoB .. RFP. Rifabutin . 18 .. rpoB Rif TB PCR . rpoB RRDR . DNA .. 1 Line Probe Assay ; LPA .. 95% . 19, 20 . 100% . 17 . INH .. RFP xpert MTB/Rif furA-katG, fabG1-inhA, . 21 . RFP DNA . RNA RNA European-American . 2 1 1 '- subunit katG 315 inhA -15 . rpoB - subunit . rpoB RFP RNA MTBDR plus Hain Lifescience, Germany.

3 LPA . 22 . RFP . RRDR Refampicin . gid / SMR. gyrB-gyrA / FQsR. rpoB / RIFR. embC-embA-embB / EMBR. rpsL / SMR. M. tuberculosis H37Rv Mbp rrs /. KMR, AMKR, KMR, CPMR. fabG1-inhA / INHR. R. oxyR' ahpC / INH. pncA / PZAR furA-katG / INHR. 1 . 14 . 197. PZA PZA Genotyping .. pH 10% . Restriction Fragment Length Polymorphisms : MGIT AST PZA RFLP Gold stan- dard . 23 .. PZA Variable Num- 24 . ber Tandem Repeat : VNTR . PZA . PZA pncA VNTR. Pyrazinoic acid PCR . pncA . PZA pncA VNTR .. 2012 12 PZA TB . LPA . 2 308 . PZA 58 . PCR LPA .. 25 . 100% .. Whole Genome Sequence : WGS .. pncA 5. pncA 7. pncA 20. pncA 1-47 pncA 21. pncA 20. pncA 21. PZA PZA PZA PZA . pncA : WT pncA : D12A pncA : 59 deletion c pncA : 365-374 deletion g232a 2 PZA TB PZA . 15 . 198. MD. Rapid molecular detection of tuberculosis and rifampin resistance.

4 N Engl J Med. 363 : 1005 -1015, 2010.. 11 Peter JG, Theron G, Muchinga TE, Govender U, Dheda K. The diagnostic accuracy of urine-based xpert MTB/RIF in HIV-infected hospitalized patients who are smear-negative or sputum scarce. PLoS One. 7 : e39966, 2012.. 12 Kazumi Y, Mitarai S. The evaluation of an identification algorithm for Myconacterium species using the 16S rRNA. coding gene and rpoB. Int J Myco. 1 : 21-28, 2012. 13 Quezel-Guerraz NM, Arriaza MM, Avila JA, S nchez- . Yebra Romera WE, Mart nez-Lirola MJ ; Indal-TB Group.. Evaluation of the Speed-oligo Mycobacteria assay for identification of Mycobacterium spp. from fresh liquid and solid cultures of human clinical samples. Diagn Microbiol Infect Dis. 68 : 123 -131, 2010.. 1 , , MGIT 14 Lee AS, Jelfs P, Sintchenko V, Gilbert GL. Identification of 8 : 269-273, non-tuberculous mycobacteria : utility of the GenoType 1998.

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6 Mutations in the rpoB. Clin Microbiol. 34 : 1083 -1085, 1996. gene of rifampin-resistant Mycobacterium tuberculosis 7 Bergmann JS, Keating WE, Woods GL. Clinical evalua- strains isolated mostly in Asian countries and their rapid tion of the BDProbeTec ET system for rapid detection of detection by line probe assay. J Clin Microbiol. 37 : 2663 - Mycobacterium tuberculosis. J Clin Microbiol. 38 : 863-865, 2666, 1999. 2000. 20 Rossau R, Traore H, De Beenhouwer H, Mijs W, Jannes 8 Boehme C C, Nabeta P, Henostroza G, Raqib R, Rahim Z, G, De Rijk P, Portaels F. Evaluation of the INNO-LiPA Rif. Gerhardt M, Sanga E, Hoelscher M, Notomi T, Hase T, TB assay, a reverse hybridization assay for the simultane- Perkins M D. Operational feasibility of using loop-mediat- ous detection of Mycobacterium tuberculosis complex and ed isothermal amplification for diagnosis of pulmonary its resistance to rifampin.

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8 Krapp F, Allen J, Tahirli R, Blakemore R, Rustomjee R, Potential for erroneous results indicating resistance when Milovic A, Jones M, O'Brien SM, Persing DH, Ruesch- using the Bactec MGIT 960 system for testing susceptibil- Gerdes S, Gotuzzo E, Rodrigues C, Alland D, Perkins ity of Mycobacterium tuberculosis to pyrazinamide. J clin 16 . 199. microbiol. 48 : 300-301, 2010. Mizuno K, Toyota E, Sejimo A, Suzuki K, Yoshida S, Saito 24 Werngren J, Sturegard E, Jureen P, Angebyc K, Hoffner T, Moriya A, Fujita A, Sato S, Matsumoto T, Ano H, Sue- S, Schon T. Reevaluation of the critical concentration for take T, Kondo Y, Kirikae T, Mori T. Comprehensive mul- drug susceptibility testing of Mycobacterium tuberculosis ticenter evaluation of a new line probe assay kit for identi- against pyrazinamide using wild-type MIC distributions fication of Mycobacterium species and detection of drug- and pncA gene sequencing.

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