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.

2 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 . 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.

3 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.

4 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.

5 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. 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.

6 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.

7 Identification of 8 : 269-273, non-tuberculous mycobacteria : utility of the GenoType 1998. Mycobacterium CM/AS assay compared with HPLC and 2 Tortoli E, Cichero P, Piersimoni C, Simonetti MT, Gesu 16S rRNA gene sequencing. J Med Microbiol. 58 : 900 - G, Nista D. Use of BACTEC MGIT 960 for recovery of 904, 2009. mycobacteria from clinical specimens : multicenter study. 15 , , , , , . J Clin Microbiol. 37 : 3578 -3582, 1999.. M. bovis .. 3 . MAC 84 2009.. 39 . 16 .. 2007. 2007 2007. 4 . 2012 . 2012. 17 Zhang Y, Yew WW. Mechanisms of drug resistance in 5 , , , , , Mycobacterium tuberculosis.

8 Int J Tuberc Lung Dis. 13 : . PCR . 1320 -1330, 2009. 38 : 1247-1253, 1990. 18 , , , .. 6 Bergmann JS, Woods GL. Clinical evaluation of the Roche Rifampicin Rifabutin .. AMPLICOR PCR Mycobacterium tuberculosis test for 84 : 631- 633, 2009. detection of M. tuberculosis in respiratory specimens. J 19 Hirano K, Abe C, Takahashi M. 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.

9 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.

10 Antimicrob Agents Chemother. tuberculosis in microscopy centers of developing coun- 41 : 2093-2098, 1997. tries. J Clin Microbiol. 45 : 1936 -1940, 2007. 21 Ando H, Kondo Y, Suetake T, Toyota E, Kato S, Mori T, 9 Mitarai S, Okumura M, Toyota E, Yoshiyama T, Aono A, Kirikae T. Identification of katG mutations associated Sejimo A, Azuma Y, Sugahara K, Nagasawa T, Nagayama with high-level isoniazid resistance in Mycobacterium N, Yamane A, Yano R, Kokuto H, Morimoto K, Ueyama tuberculosis. Antimicrob Agents Chemother. 54 : 1793 - M, Kubota M, Yi R, Ogata H, Kudoh S, Mori T.